Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P74

Head and Neck

P74
Otolaryngology-Head and Neck Surgery 163(1S)
Presentation schedule is subject to change. The Official Program Abstracts supplement does not reflect changes made after August 10, 2020.
consensus on the recommended regimen. We examined whether
alone remained significant on multivariate Cox regression
pre- and postoperative anticoagulation in patients who under(hazard ratio [HR], 1.18-1.95; P = .001). Among patients with
went MFTT was associated with postoperative complications
PNI, nerve burden and size did not retain an association with
including blood transfusion and hematoma.
DSS on multivariate analysis.
Methods: A retrospective review of patients who underwent
Conclusions: Presence of PNI showed worse DSS in OSCC.
head and neck MFTT at our institution from July 2018 to
PNI status is significantly associated with nodal spread and
September 2019 was performed. Variables included patient
distant recurrence. This is the first large-scale study to demondemographics, pre- and postoperative anticoagulation, blood
strate that involved nerve size and burden do not significantly
loss, osseous vs nonosseous flaps, and flap failure. Primary
impact disease-specific outcomes. The findings show that
outcome measures included blood transfusions and postoperacareful histopathological identification of PNI is paramount.
tive hematomas.
Results: A total of 247 patients were included. Ninety-nine
Perioperative Antibiotic Prophylaxis in Head
patients received blood transfusions, 32 developed hematoand Neck Surgery-A Global Perspective
mas, and 20 had flap failure. Patients with lower height (P <
Carlos M. Chiesa-Estomba, MD (Presenter); Johannes
.01) and weight (P < .01) were more likely to be transfused.
Jacobus Fagan, MBChB, FCS(SA)
Patients on therapeutic anticoagulation preoperatively were
Objectives: Surgical site infection (SSI) in clean head and
more likely to receive transfusion (P < .01) but not develop
neck surgical procedures without antimicrobial prophylaxis
hematomas. Those taking aspirin preoperatively had higher
range from < 1% to 3%. In contrast, infection rates in patients
rates of hematomas (P < .01) but were not more likely to be
undergoing complicated cancer surgery are high, ranging
transfused. Patients with greater operative blood loss (P < .01)
from 24% to 87% of patients without antimicrobial prophyand osseous reconstruction (P < .05) were more likely to be
laxis. Antimicrobial resistance represents a global threat and
transfused. Patients requiring therapeutic anticoagulation
causes almost 700,000 deaths each year. The rapid disseminapostoperatively were more likely to be transfused (P < .01)
tion of resistant bacteria is occurring globally, turning this into
and develop hematomas (P < .01). Flap failure was correlated
the primary threat to public health in the 21st century and forcwith both transfusion (P < .01) and hematoma (P < .01).
ing organizations around the globe to take urgent action.
Conclusions: We demonstrated factors, including anticoaguMethods: A systematic review was performed in accordance
lation regimens, that increase the risk of bleeding and hemawith Preferred Reporting Items for Systematic Reviews and
toma in head and neck MFTT.
Meta-Analyses (PRISMA) guidelines. Evidence about the use
of antibiotics in head and neck surgery from January 2004 to
Postoperative Radiation Versus
January 2020 were included. Inclusion criteria for considering
Chemoradiation for Metastatic Cutaneous
studies for the systematic review were based on the PICO
Squamous Cell Carcinoma Involving the
framework.
Parotid Gland
Results: One hundred twenty-two papers were included for
Sallie Long, MD (Presenter); Stephanie Flukes, MD; Jennifer
analysis. Data about risks related to SSI in head and neck surCracchiolo, MD; Christopher Barker, MD; Lara Dunn, MD;
gery, surgical limitations and evidence about surgical prophyMarc A. Cohen, MD
laxis from resource-constrained settings, comorbidities and
Objectives: The standard of care for metastatic squamous
the risk of SSI, and the SSI gap between the developed and
cell
carcinoma (SCC) involving the parotid gland is resection
developing worlds and how to reduce resistance were revised.
followed
by postoperative radiation (PORT), but the role of
Conclusions: Antibiotic prophylaxis can decrease the inciadjuvant
chemoradiation
(POCRT) is less well defined. The
dence of SSI in selected head and neck surgeries. Antibiotic
addition
of
chemotherapy
has been extrapolated from its use
protocols can be adjusted to local and regional bacterial resisin
mucosal
SCC,
but
results
have not shown consistent theratance profiles, taking into account availability of antibiotics
peutic
benefit
in
the
management
of cutaneous SCC.
and cost limitations on each country to decrease SSI risk.
Methods: A retrospective review was performed for patients
with metastatic SCC involving the parotid gland treated with
Postoperative Anticoagulation and
surgery at a high-volume academic center from 1992 to 2015.
Association With Risk of Bleeding and
Outcomes were locoregional control (LRC), overall survival
Hematoma in Head and Neck Free Flap
(OS), and disease-specific survival (DSS). Demographics,
Reconstruction
tumor characteristics, treatment, and outcome information
Sarah Nyirjesy, MD (Presenter); Akina Tamaki, MD;
were collected. Patients lost to follow-up before 1 year were
Songzhu Zhao, MS; Margaret Heller; Stephen Y. Kang, MD;
excluded. Categorical variables and survival outcomes were
Matthew O. Old, MD
analyzed using chi-square test and Kaplan-Meier curves.
Results: Eighty-four patients with a mean age of 71 years
Objectives: Microvascular free tissue transfer (MFTT) is a
were included. The male to female ratio was 7:1. Grade, marcritical aspect of complex reconstruction of head and neck
gin status, and extracapsular spread were not significantly difdefects. Most reconstructive surgeons use some type of
ferent between groups. Treatment was surgical resection
anticoagulation following reconstruction, but there is not

Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

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