Reconstructive outcomes in patients with head and neck sarcoma.

BACKGROUND Limited data exist regarding reconstructive outcomes in patients with head and neck sarcoma. METHODS A review of patients with head and neck sarcoma who underwent oncologic resection and microvascular free flap reconstruction between 2001 and 2010 was performed. RESULTS In all, 133 patients were included in the study. The overall rate of perioperative complications was 30.1%, including a flap loss rate of 3.0%. The rate of late recipient site complications was 7.5% and occurred more frequently with postoperative radiation (19.0%) compared with preoperative radiation, prior radiation, and no radiation (5.3%, 3.0%, and 0%, respectively; p = .005). Most patients achieved intelligible speech (88.3%) and feeding tube independence (94.4%). CONCLUSIONS Good reconstructive outcomes can be attained in patients with head and neck sarcoma undergoing resection and free flap reconstruction. Preoperative radiation may be preferable to postoperative radiation in select cases due to fewer long-term complications without an increased rate of complications or flap loss.