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Risk Factors of Smith et al for Aspiration Following Free Flap Reconstruction Following an Oral Cavity or Oropharyngeal Tumor Resection

Description

Smith et al evaluated patients who had a free flap reconstruction for an oral cavity or oropharyngeal defect after a tumor resection. They identified patients at risk for aspiration who may benefit from more aggressive management. The authors are from the University of California at Los Angeles.


 

Patient selection: tumor of the oral cavity or oropharynx with large defect after surgical resection

 

Risk factors for aspiration found on multivariate analysis:

(1) history of radiation therapy to the tumor

(2) surgical removal of > 50% of the tongue base

 

A patient with either of these risk factors is at increased risk for aspiration, especially during the first 3 months after surgery. These patients may benefit from placement of a gastrostomy tube.

 

Additional risk factors (from the univariate analysis):

(1) sacrifice of the hypoglossal nerve

(2) presence of a mandibular osteotomy

(3) lymph node metastases (N stage)

 


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