Department of Head & Neck Surgery, University College Hospital, London, UK.
Charles Wolfson Center for Reconstructive Surgery, Royal Free Hospital, London, UK.
Head Neck. 2019 Oct;41(10):3647-3655. doi: 10.1002/hed.25888. Epub 2019 Aug 7.
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.
头颈部癌症的多模态治疗会导致显著的功能和美观损伤，主要表现为放射性皮肤纤维化（RIF）与容积缺陷相结合，并降低颈部活动度。本研究评估了脂肪转移作为头颈部恶性肿瘤患者二次手术的一部分的影响。
回顾性分析 2005 年至 2016 年期间的数据。所有患者均有头颈部恶性肿瘤病史，接受过包括手术或放疗在内的多模态治疗，且无病生存时间至少 2 年。38 例患者（22 例男性，16 例女性）符合纳入标准。
37 例（97%）患者在随访 32 个月时报告 RIF 和容积缺陷的美观和功能得到改善。24 例（63%）患者和外科医生报告了美观和功能结果的显著改善，13 例患者和外科医生报告了轻微改善（34%），且无任何并发症。脂肪转移还显著改善了患者术后的心理健康，Derriford 外观量表（DAS24）、简明健康调查问卷（SF-36）和华盛顿大学生活质量问卷（UW-QOL V4）评分均显著改善（P <.001）。
脂肪转移对头颈部缺陷的体积恢复和治疗疤痕及 RIF 有效。
