Aktueller Stand der chirurgischen Expertise bei plastischrekonstruktiven Verfahren im Rahmen tumorchirurgischer Interventionen in den Deutschen Hals-Nasen-Ohrenkliniken

Worldwide the overall percentage of head and neck squamous cell cancer in all newly diagnosed cancers is 5.9%. In Germany alone as many as 17.000 were diagnosed in 2007. Nowadays the primary therapy in North America and Europe is often radiation treatment or a combined radiochemotherapy. Surgery on these types of cancers is often performed in cases of relapse or in a salvage situation. Unfortunately in such cases there is a high risk of healing disorder. Flaps for head and neck reconstruction are helpful in minimizing this risk. Furthermore they contribute to a good functional and cosmetic result following ablating surgery. Surgical flaps are to be subdivided into pedicled ones and flaps with microvascular anastomosis ( free flaps ). The latter are by far the more challenging technique but offer possibilities that surpass those of pedicled flaps. In this study the number of flaps in general and what kind of flaps are used most commonly was investigated. In order to do so a questionnaire was created that was sent to the heads of German Head & Neck Units. All of the listed flaps are performed in German Head & Neck Units. Amongst the pedicled ones the Pectoralis Major Myocutaneous Flap is the most common one as is the Radial Forearm Free Flap amongst the free ones. In comparison mandibular reconstructive flaps are used seldomly. In many departments head and neck reconstruction surgery is performed by the Head & Neck Units which demonstrates a great degree of autonomy. Solely the jejunum flap requires the support of another surgical discipline. At university clinics and larger Head & Neck Units the amount of flaps performed in total as the proportion of such as treatment in newly diagnosed HNSCC is significantly higher than in smaller departments. Furthermore the amount of free flap surgery performed in such clinics is higher.