Subjective morbidity following fibular free flap reconstruction in head and neck cancer patients

J Laryngol Otol. 2018 Aug;132(8):729-733. doi: 10.1017/S0022215118001068. Epub 2018 Jul 24.

Abstract

Objective: This study aimed to evaluate the presence of subjective post-operative donor site morbidity after fibula free flap reconstruction in head and neck cancer patients, utilising three validated instruments: the 36-item Short Form Health Survey, the Short Musculoskeletal Function Assessment questionnaire and the Lower Limb Core Scale.

Methods: In this retrospective study, all head and neck cancer patients who underwent fibula free flap reconstruction between January 2009 and July 2014 were identified. All questionnaires and their respective subcomponents were scored.

Results: Twenty-one cases were included. Patients were found to have a higher Short Musculoskeletal Function Assessment bothersome index (22.42 vs 13.77, p = 0.03), a lower Short Form 36 Health Survey Physical Component Summary score (42.44 vs 50, p < 0.01) and a decreased Lower Limb Core Scale score (47.08 vs 90.52, p < 0.01), compared to US population norms. The Short Form 36 Health Survey Mental Component Summary scores and Short Musculoskeletal Function Assessment function index failed to demonstrate significant differences. Gender affected overall disability.

Conclusion: In this study, significant long-term disability was demonstrated after fibular flap reconstruction, as measured by the Lower Limb Core Scale.

Keywords: Fibula; Free Tissue Flaps; Head And Neck Neoplasms; Lower Extremity; Reconstructive Surgical Procedure.

MeSH terms

  • Adult
  • Aged
  • Female
  • Fibula / transplantation*
  • Free Tissue Flaps*
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Male
  • Middle Aged
  • Plastic Surgery Procedures*
  • Postoperative Complications / etiology*
  • Retrospective Studies
  • Time Factors
  • Tissue and Organ Harvesting / adverse effects*
  • Transplant Donor Site*