Evaluation of the efficacy of lipotransfer to manage radiation-induced fibrosis and volume defects in head and neck oncology.


Journal

Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541

Informations de publication

Date de publication:
10 2019
Historique:
received: 04 03 2019
revised: 03 07 2019
accepted: 11 07 2019
pubmed: 8 8 2019
medline: 12 9 2020
entrez: 8 8 2019
Statut: ppublish

Résumé

Multimodality treatment for head and neck cancer leads to substantial functional and esthetic impairment mainly manifested as radiation-induced skin fibrosis (RIF) in combination with volumetric defects and reduction in neck mobility. This study assessed the impact of lipotransfer as part of secondary surgical procedure(s) in patients treated for head and neck malignancies. Retrospective analysis was performed between 2005 and 2016. All patients with a history of head and neck malignancy, multimodal treatment including at least surgery or radiotherapy, and at least 2-year disease-free survival were included. Thirty-eight patients (22 men, 16 women) matched the inclusion criteria. Thirty seven (97%) reported esthetic and functional improvements in their RIF and volumetric defect at follow-up of 32 months. Major improvement in esthetic and functional outcome was reported by 24 (63%) patients and surgeons and minor by 13 patients and surgeons (34%) without causing any complications. Lipotransfer was also found to significantly improve patient's psychological health postoperatively as showed by significant improvements in Derriford Appearance Scale (DAS24), Short Form Health Survey (SF-36), and University of Washington Quality of Life Questionnaire (UW-QOL V4) scores (P < .001). Lipotransfer is effective for volume restoration and treating scar and RIF from head and neck defects.

Sections du résumé

BACKGROUND
Multimodality treatment for head and neck cancer leads to substantial functional and esthetic impairment mainly manifested as radiation-induced skin fibrosis (RIF) in combination with volumetric defects and reduction in neck mobility. This study assessed the impact of lipotransfer as part of secondary surgical procedure(s) in patients treated for head and neck malignancies.
METHODS
Retrospective analysis was performed between 2005 and 2016. All patients with a history of head and neck malignancy, multimodal treatment including at least surgery or radiotherapy, and at least 2-year disease-free survival were included. Thirty-eight patients (22 men, 16 women) matched the inclusion criteria.
RESULTS
Thirty seven (97%) reported esthetic and functional improvements in their RIF and volumetric defect at follow-up of 32 months. Major improvement in esthetic and functional outcome was reported by 24 (63%) patients and surgeons and minor by 13 patients and surgeons (34%) without causing any complications. Lipotransfer was also found to significantly improve patient's psychological health postoperatively as showed by significant improvements in Derriford Appearance Scale (DAS24), Short Form Health Survey (SF-36), and University of Washington Quality of Life Questionnaire (UW-QOL V4) scores (P < .001).
CONCLUSIONS
Lipotransfer is effective for volume restoration and treating scar and RIF from head and neck defects.

Identifiants

pubmed: 31389085
doi: 10.1002/hed.25888
doi:

Types de publication

Evaluation Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

3647-3655

Subventions

Organisme : European Association for Cranio Maxillo Facial Surgery
Pays : International

Informations de copyright

© 2019 Wiley Periodicals, Inc.

Références

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Auteurs

Michelle F Griffin (MF)

Department of Head & Neck Surgery, University College Hospital, London, UK.
Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, UK.
Department of Plastic Surgery, Royal Free Hospital, London, UK.
The Charles Wolfson Center for Reconstructive Surgery, Royal Free London NHS Foundation Trust Hospital, London, UK.

Jelovac Drago (J)

Department of Head & Neck Surgery, University College Hospital, London, UK.
Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, UK.
Department of Plastic Surgery, Royal Free Hospital, London, UK.

Aurora Almadori (A)

Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, UK.
Department of Plastic Surgery, Royal Free Hospital, London, UK.
The Charles Wolfson Center for Reconstructive Surgery, Royal Free London NHS Foundation Trust Hospital, London, UK.

Nicholas Kalavrezos (N)

Department of Head & Neck Surgery, University College Hospital, London, UK.

Peter E Butler (PE)

Department of Head & Neck Surgery, University College Hospital, London, UK.
Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, UK.
Department of Plastic Surgery, Royal Free Hospital, London, UK.
The Charles Wolfson Center for Reconstructive Surgery, Royal Free London NHS Foundation Trust Hospital, London, UK.

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