Cervicofacial rhytidectomy after head and neck tumor removal.

Abstract

To compare intraoperative and postoperative complication rates of cervicofacial rhytidectomy after head and neck tumor removal with complication rates of rhytidectomy in the normal patient population. Retrospective chart review and literature review. A sample of 11 patients treated by a single surgeon (D.A.S.) at an academic referral center who met the inclusion criteria was reviewed for previous head and neck surgical history, medical history, and surgical results and subsequent complications of the facial esthetic procedure. These rates were compared with the complication rates for cervicofacial rhytidectomy in normal patients as quoted in the general medical literature. Patients ranged in age from 48 to 75 years (mean age, 58 y). Of the 11, no patient experienced a major complication of rhytidectomy, and two experienced a minor postoperative complication. Both patients had received postoperative radiation for the treatment of their previous tumor, and both noted a small (<1.5 cm) area of wound dehiscence before postoperative day 10, which required no revision and healed without sequelae. No other intraoperative or postoperative complications were found. Cervicofacial rhytidectomy may be safely and effectively performed on postoperative patients with head and neck tumors without increased incidence of major complications when compared with patients without a surgical tumor history. The increased incidence of minor wound dehiscence experienced by 2 of the 3 patients who received postoperative radiation in this study may indicate that small areas of skin incision dehiscence are more likely in patients who have been radiated. Surgeons performing rhytidectomy on patients with head and neck tumors who were previously radiated should consider more meticulous subdermal closure to avoid such dehiscence. Patients should be informed of the slightly higher risk of dehiscence before surgery.