COMPLICATIONS OF MICROVASCULAR HEAD AND NECK-SURGERY IN THE ELDERLY

Objectives: To evaluate the complications of head and neck reconstruct ion using microvascular free tissue transfers (MFTTs) performed in an elderly population and to determine whether these complications are mo re common than in a younger population. Setting: Tertiary referral cen ter. Patients and Design: Retrospective, consecutive chart review of p atients older than 70 years who underwent MFTT in the past 5 years (gr oup 1). The complications in this population were compared with those in a second group (group 2) of consecutive patients younger than 70 ye ars who were matched according to the site of the primary tumor. Main Outcome Measures: Surgical and medical complications. Results: The med ian age for group 1 was 74 years and for group 2, 55 years. The overal l complication rate for group 1 was 48%, compared with 57% for group 2 . In group 1, surgical morbidity was less common and medical morbidity was more common than in group 2. Mortality rate was 6% for group 1 an d 0% for group 2. The types of complications were similar for both gro ups. There was no difference in complication rates when complications were classified by site of the defect, patient status determined by Am erican Society of Anesthesiologists classification, or use of preopera tive radiation. The overall success rate of MFTT was 100% for group 1 and 94% for group 2. Conclusions: Microvascular free tissue transfers for head and neck reconstruction can be safely performed in the elderl y. An age older than 70 years does not increase the rate of surgical c omplications following head and neck reconstruction with MFTT. Medical complications, however, are more common and are equally divided betwe en bronchopulmonary and cardiovascular effects.