HN04 THE EVOLUTION OF THE WELLINGTON HEAD & NECK AND SKULL BASE SURGERY SERVICE – AN ANALYSIS

Abstract

Aims: To improve our head & neck and skull base surgery service, over the last decade, we have expanded the multidisciplinary head & neck clinics, recruited additional surgeons with appropriate skills, increased resources such as theatre access, and prospective data collection. We have also introduced novel approaches including routine immediate facial reanimation, based on our central philosophy that ‘head and neck surgery is about the quality of life’. The effects of this strategy have been captured by our prospective database established in 2000. This paper demonstrates the impact of these changes upon our service.Methods: Patients undergoing head and neck surgery were culled from our prospective database 2000–2008 and compared with those treated 1990–1999. Analyses included overall numbers, tumour distribution and stage, the use of free tissue transfer and facial reanimation, complication rates and oncological outcomes.Results: Between 2000 and 2008, 682 new patients were evaluated at the head & neck clinics, 59% of whom had Stage III or IV disease, and 56% were squamous cell carcinoma. 182 free tissue flaps and 251 nodal dissections were performed, 156 of which were for nodal metastasis. The recurrence and mortality rates were 23% and 10% respectively.Conclusions: Since 2000, our multidisciplinary head & neck and skull base service has expanded in both patient numbers and reconstructive complexity, including routine immediate facial reanimation and a quadruple rate of free flap reconstruction. Future directions are discussed.