文章基本信息

标题：Reconstructive methods to resolve intractable fistulas that develop after radiation therapy in patients with head and neck cancer
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作者：Bu Hyeon Choi ; Seong Oh Park ; Hee Chang Ahn 等
期刊名称：Archives of Craniofacial Surgery
印刷版ISSN：2287-1152
出版年度：2021
卷号：22
期号：5
页码：247-253
DOI：10.7181/acfs.2021.00353
语种：English
出版社：KoreaMed Synapse
摘要：Background Radiation therapy (RT) is frequently used for supportive treatment and management of advanced head and neck cancers. This study performed a retrospective review of the treatment methods that were used for intractable draining fistulas in seven patients who had received RT for head and neck cancers. Treatment methods used for two of the seven patients are presented in detail. Methods From 2009 to 2020, seven patients underwent reconstructive surgery for intractable fistulas which occurred after RT for head and neck cancers. Patient characteristics, medical history, treatment method, and treatment outcome were reviewed for each case. The type of surgery performed, failure rate, and treatment period were also analyzed. Results In this study, a total of seven patients received additional management for radiation-induced fistulas. Patients underwent a mean of 3.3± 1.4 surgeries (maximum: six surgeries) to resolve their fistulas. The mean time interval from the first surgery to the last surgery for the patients to achieve resolution of the fistula was 8.7 months. Loco-regional flaps have performed an average of 1.9± 1.5 times. However, all loco-regional flaps failed. Instead, the patients’ intractable fistulas were resolved with the use of distant flaps or free tissue transfers. Conclusion Fistulas that develop after head and neck cancer treatment following RT are difficult to treat with simple loco-regional flap procedures. Therefore, more aggressive treatment techniques, such as distant flap or free tissue transfer, may be needed to shorten patients’ treatment periods and avoid unnecessary surgeries.
关键词：enFistula;Free tissue flaps;Head and neck neoplasms;Radiotherapy