Skip to main content
AAO-HNSF 2026 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.

Scientific Oral Presentation

Head and Neck Surgery

Impacts of Prior Radiotherapy on Outcomes of Free Tissue Transfer: A Multi-institutional Review

Sunday, October 18, 2026
2:30 PM - 2:36 PM PT
Location: West Exhibit Hall A, Learning Zone 3

    Presenting Author(s)

  • Morgan A. Terry, MD

    Resident Physician
    Oregon Health & Science University
    Portland, OR, United States

    • Co-Author(s)

  • AP

    Alisa L. Phillips, MD

    Resident Physician
    Oregon Health & Science University
    Portland, Oregon, United States

  • MP

    Madeline Pyle, MD

    Resident Physician
    Miami University
    Miami, Florida, United States

  • EK

    Elise Krippaehne, BS

    Research Fellow
    Oregon Health & Science University, United States

  • Farshid Taghizadeh, MD

    Resident Physician
    OHSU
    Portland, OR, United States

  • Mark K. Wax, MD

    Professor of Otolaryngology - Head and Neck Surgery, School of Medicine
    Oregon Health & Science University
    Portland, OR, United States

    • Senior Author(s)

  • LS

    Larissa Sweeny, MD

    Associate Professor, Otolaryngology - Head and Neck Surgery
    University of Miami Health System
    Miami, Florida, United States

Disclosure(s):
Morgan A. Terry, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Mark K. Wax, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Prior radiation therapy (RT) is a known risk factor contributing to impaired wound healing but specific impact on outcomes following free tissue transfer reconstruction is under reported. This study evaluates how previous RT influences perioperative morbidity in patients undergoing head and neck free tissue transfer.

Methods: A multi-institutional retrospective analysis compared patients with and without prior radiation therapy undergoing H&N free tissue transfer from 2010-2024 and their perioperative factors.

Results: There were 2,703 patients who underwent free tissue transfer, 962 (35.59%) had prior radiation therapy. Patients with prior RT were older (p=0.0072) and demonstrated significant differences in T-classification (p=0.0105) and neck dissection patterns (p < 0.0001). Among comorbidities, patients with RT had higher rates of hypothyroidism (OR 2.14; 95% CI 1.75–2.62; p< 0.0001), higher TSH levels (p=0.0358), and COPD (OR 1.45; 95% CI 1.14–1.86; p=0.0028). A number of perioperative complications were significantly associated with prior radiation therapy exposure including intraoperative thrombectomy (2.52% vs 4.51%; OR 0.54; 95% CI 0.34-0.88; p=0.0126), salivary leak (6.21% vs 9.07%; OR 1.51; 95% CI 1.12-2.02; p=0.0059), postoperative sepsis (2.70% vs 4.58%; OR 1.73; 95% CI 1.13-2.63; p=0.0095), and 30-day readmission (14.15% vs 18.39 %; OR 1.37; 95% CI 1.11-1.69; p=0.0038). No differences were observed in operative time, flap type, pedicle revision, flap compromise, flap salvage, flap failure.

Conclusions: Prior radiation therapy significantly shapes the clinical profile of patients undergoing head and neck FTT reconstruction. Although RT did not impact flap survival or major perioperative complications, it was associated with higher rates of intraoperative thrombectomy, salivary leak, postoperative sepsis, and hospital readmission. RT patients also exhibited distinct comorbidity patterns—including increased TSH, COPD, and lower BMI—reflecting broader systemic effects of radiation.