Aktueller Stand der chirurgischen Expertise bei plastischrekonstruktiven Verfahren im Rahmen tumorchirurgischer Interventionen in den Deutschen Hals-Nasen-Ohrenkliniken
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Philipps-Universität Marburg
Abstract
Worldwide the overall percentage of head and neck squamous cell cancer
in all newly diagnosed cancers is 5.9%. In Germany alone as many as
17.000 were diagnosed in 2007. Nowadays the primary therapy in North
America and Europe is often radiation treatment or a combined
radiochemotherapy. Surgery on these types of cancers is often performed
in cases of relapse or in a salvage situation. Unfortunately in such cases
there is a high risk of healing disorder. Flaps for head and neck
reconstruction are helpful in minimizing this risk. Furthermore they
contribute to a good functional and cosmetic result following ablating
surgery.
Surgical flaps are to be subdivided into pedicled ones and flaps with
microvascular anastomosis ( free flaps ). The latter are by far the more
challenging technique but offer possibilities that surpass those of pedicled
flaps.
In this study the number of flaps in general and what kind of flaps are used
most commonly was investigated. In order to do so a questionnaire was
created that was sent to the heads of German Head & Neck Units.
All of the listed flaps are performed in German Head & Neck Units.
Amongst the pedicled ones the Pectoralis Major Myocutaneous Flap is the
most common one as is the Radial Forearm Free Flap amongst the free
ones. In comparison mandibular reconstructive flaps are used seldomly. In
many departments head and neck reconstruction surgery is performed by
the Head & Neck Units which demonstrates a great degree of autonomy.
Solely the jejunum flap requires the support of another surgical discipline.
At university clinics and larger Head & Neck Units the amount of flaps
performed in total as the proportion of such as treatment in newly
diagnosed HNSCC is significantly higher than in smaller departments.
Furthermore the amount of free flap surgery performed in such clinics is
higher.
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This item has been published with the following license: In Copyright