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Review
. 2024 Aug 14;13(16):4790.
doi: 10.3390/jcm13164790.

Reconstructive Surgery of the Head and Neck in Organ Transplant Recipients: A Case Report and a Review of the Literature

Andrea Rampi  1 , Lara Valentina Comini  2 , Andrea Galli  3   4 , Bright Oworae Howardson  3   4 , Alberto Tettamanti  3   4 , Paolo Luparello  2 , Gabriele Redaelli  1 , Davide Di Santo  2 , Stefano Bondi  2
Affiliations
Review

Reconstructive Surgery of the Head and Neck in Organ Transplant Recipients: A Case Report and a Review of the Literature

Andrea Rampi et al. J Clin Med. .

Abstract

The number of solid organ transplant recipients (SOTRs) is growing as a consequence of an increase in transplantations and longer survival; these patients, thus, frequently suffer various comorbidities and are subjected to the detrimental effects of immunosuppressive agents, which expose them to a higher risk of developing malignancies. These drugs also complicate the surgical treatment of neoplasms, as they can hinder wound healing, especially when associated with other unfavorable factors (e.g., previous radiotherapy, diabetes, etc.). We herein present our experience with a 74-year-old SOTR who underwent a radical extended parotidectomy and reconstruction with a submental island flap for a persistent cutaneous squamous carcinoma after radiotherapy; his complicated clinical course was characterized by incredibly slow wound healing. The current literature was reviewed to provide a succinct overview of the main difficulties of head and neck surgery in SOTRs. In particular, the immunosuppressive regimen can be tapered considering the individual risk and other elements should be carefully assessed, possibly prior to surgery, to prevent cumulative harm. New developments, including intraoperative monitoring of flap vascularization through indocyanine green fluorescence video-angiography and the prophylactic application of negative pressure wound therapy, when feasible, may be particularly beneficial for high-risk patients.

Keywords: head and neck surgery; immunosuppressive agents; reconstructive flaps; solid organ recipients; wound healing.

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Conflict of interest statement

The authors declare no conflicts of interests.

Figures

Figure 1
Figure 1
A CT scan displaying the skin neoplasm with deep invasion of the underlying parotid gland, the masseter muscle, and the anterior wall of the external auditory canal in its cartilaginous portion.
Figure 2
Figure 2
Multiple wound dehiscences in the pre-, infra- and retro-auricular region, with exposure of the mandibular condyle and the mastoid. No evidence of flap failure, which appears to be trophic and well-vascularized.
Figure 3
Figure 3
Advanced wound care.
See this image and copyright information in PMC

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