Microsurgical free flap transfer in previously irradiated and operated necks: Feasibility and safety

Hideki Kadota, Junichi Fukushima, Sei Yoshida, Kenichi Kamizono, Yoshihiko Kumamoto, Muneyuki Masuda, Torahiko Nakashima, Ryuji Yasumatsu, Shizuo Komune

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Objectives: Microsurgery is difficult to perform in necks that have been previously irradiated and operated upon because of the limited availability of recipient vessels. The objective of this study was to clarify the feasibility and safety of performing microsurgery in necks that are scarred and fibrous owing to previous treatment. Methods: Twenty patients whose necks were previously irradiated and operated upon and who underwent free tissue transfer were included in this study. All patients had been previously administered an average of 60.7 (range, 30-95). Gy of radiotherapy. Thirteen patients had undergone hemilateral neck dissections, 5 patients had undergone bilateral neck dissections, 8 patients had undergone (pharyngo)laryngectomies, and 10 patients had undergone prior flap transfer. The success rate of microsurgery and the selection of recipient vessels were examined. Results: All recipient vessels could be adopted in the neck field without vessel grafting. One patient developed necrosis of the flap, which was salvaged with retransfer of another flap after trimming the same cervical vessels. For the remaining 19 patients, free tissue transfers were successful. Conclusions: Suitable recipient vessels are residual and available even in the previously irradiated and operated neck field. When performed properly, free tissue transfer in the previously treated neck is not as risky a surgery as was generally believed.

Original languageEnglish
Pages (from-to)496-501
Number of pages6
JournalAuris Nasus Larynx
Issue number5
Publication statusPublished - Oct 2012

All Science Journal Classification (ASJC) codes

  • Surgery
  • Otorhinolaryngology


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