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01-01-2008 | Head and Neck Oncology

Microsurgical Tissue Transfers for Head and Neck Reconstruction in Patients with Alcohol-Induced Mental Disorder

Authors: Yur-Ren Kuo, MD, PhD, FACS, Seng-Feng Jeng, MD, FACS, Kuan-Miao Lin, MD, Szu-Jen Hou, MD, Chih-Ying Su, MD, Chih-Yen Chien, MD, Ker-Li Hsueh, MD, Eng-Yen Huang, MD

Published in: Annals of Surgical Oncology | Issue 1/2008

Abstract

Background

Free tissue transfer in patients with organic mental disorder has always been known to be risky. Herein, the outcomes of free tissue transfers for head and neck reconstruction in those with alcohol-induced mental disorder were analyzed.

Materials and methods

We retrospectively reviewed and analyzed data from the past 10 years of 1,364 patients who had undergone microsurgical tissue transfers after head and neck cancer ablation. Among them, 54 patients had been diagnosed with alcohol-induced mental disorders post-operatively. Age ranged from 33 to 71 years. Alcohol-drinking history averaged 17.5 years. Reconstructive procedures included 25 forearm flaps, 13 anterolateral thigh (ALT) flaps, 10 fibula osteocutaneous flaps, and 6 double flaps (fibula+ALT). The outcomes and complications were analyzed.

Results

Onset periods ranged from the first to fourth days post-operatively. Duration of alcohol withdrawal or delirium tremens was 3–10 days. All patients gradually stabilized after immediate psychiatric consultation and intensive medical treatment. The flap survival rate in patients with alcohol withdrawal was significantly decreased in comparison with patients not suffering alcohol withdrawal (83% versus 96.4%, P < 0.001). During this critical post-operative period, 28 (52%) patients with alcohol withdrawal syndrome experienced complications; 26 (48%) suffered flap-related complications, and 19 (35.2%) required additional surgery. The analytical parameters revealed that secondary operative procedures and duration of hospitalization differed significantly between the complication and non-complication groups (P < 0.001).

Conclusion

Higher rates of complications and level of critical care were needed in patients with alcohol-induced mental disorder after head and neck microsurgical reconstructions. Treatment requires a multidisciplinary approach, rapid diagnosis, and intensive medical care.

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Title: Microsurgical Tissue Transfers for Head and Neck Reconstruction in Patients with Alcohol-Induced Mental Disorder
Authors: Yur-Ren Kuo, MD, PhD, FACS
Seng-Feng Jeng, MD, FACS
Kuan-Miao Lin, MD
Szu-Jen Hou, MD
Chih-Ying Su, MD
Chih-Yen Chien, MD
Ker-Li Hsueh, MD
Eng-Yen Huang, MD
Publication date: 01-01-2008
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 1/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-007-9506-5

At a glance: The STEP trials

Springer Medicine

Microsurgical Tissue Transfers for Head and Neck Reconstruction in Patients with Alcohol-Induced Mental Disorder

Abstract

Background

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

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