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Planificación preoperatoria mediante estudios de mapeo vascular en microcirugía reconstructiva de cabeza y cuello

La reconstrucción microquirúrgica se ha convertido en el patrón oro para la reparación funcional y estética de defectos complejos del territorio de cabeza y cuello. El principal factor de éxito en la reconstrucción mediante colgajos libres es la experiencia del equipo quirúrgico. La angiotomografía computerizada, la angiorresonancia magnética y la ecografía Doppler son pruebas de alta resolución vascular que pueden tener indicación como pruebas de mapeo en la planificación de procedimientos de reconstrucción microquirúrgica. Las nuevas técnicas de estudio preoperatorio de colgajos en cirugía reparadora pueden aportar información relevante para la planificación y la toma de decisiones y aumentar la fiabilidad y seguridad del proceso del tallado y transferencia de los colgajos. La adecuada selección del paciente y del tipo de colgajo a utilizar es fundamental para optimizar los resultados..

Assessment of Quality of Life in Head-and-Neck Oncologic Patients with Intraoral Soft-Tissue Defects Reconstructed with Buccinator Myomucosal Flap

The aim of this study is to evaluate the functional outcomes and quality of life (QoL) in oncologic patients with intraoral defects reconstructed with the buccinator myomucosal flap. A retrospective study was performed involving 39 patients with intraoral soft-tissue defects, reconstructed with a buccinator myomucosal flap during a six-year period. Patients completed the European Organization for Research and Treatment of Cancer questionnaires, the standard questionnaire (QLQ-C30) and the head-and-neck specific module (QLQ-H&N35). Thirty-nine patients with a mean age of 61.23 ± 15.80 years were included in the study. Thirty-three patients were diagnosed with an oncological condition (84.61%). Six patients (15.38%) developed orosinusal communication and underwent extensive debridement. The median global-health-status score was 79.27 and emotional performance was the lowest scoring, with a mean score of 76.93. As for the symptom items, the most outstanding were dental problems (33.33), oral opening (31.62) and dry mouth (37.61), followed by sticky saliva (24.79), problems with social eating (21.15) and pain (19.87). The most significant symptoms were radiotherapy-related adverse effects such as pain, fatigue, dental problems and dry mouth. Patients reconstructed with the buccinator myomucosal flap develop a good quality of life for all types of activities, and a correct function and aesthetics. Postoperative radiotherapy is associated with a poorer quality of life, and can lead to impairment of several symptoms such as swallowing, oral opening and dry mouth.Depto. de Salud Pública y Materno - InfantilFac. de MedicinaTRUEpu