Complications of Microvascular Head and Neck Surgery in the Elderly

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Abstract
THE MORE widespread application of microvascular free tissue transfer (MFTT) during the past 20 years has revolutionized head and neck reconstruction. While the safety and success of MFTT has been well documented in the general population,1 the utility of MFTT in the elderly has received little attention. The surgeon faced with an elderly patient with advanced head and neck cancer must weigh the risks and benefits of operating on this sometimes frail population. While perioperative mortality after head and neck surgery in the elderly is substantially less than after cardiovascular or gastrointestinal tract surgery,2 other issues warrant consideration if a lengthy reconstruction is planned. Can the elderly patient tolerate the medical insult of prolonged surgery? Are the surgical complications higher? Should major surgical reconstruction even be considered in this older population? Of course, these issues must be balanced against the presumed functional and aesthetic benefits that are gained by microvascular surgery.