Improving Outcomes in Complex Head and Neck Cancer Surgery: Prehabilitation through Enhanced Recovery

Tuesday, October 14, 2025

1:00 PM - 2:00 PM EDT

Location: 128

Disclosure(s):

Matthew J. Mifsud, MD FACS:

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

Sid V. Puram, MD, PhD, FACS:

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

PROGRAM DESCRIPTION: This panel discussion will explore the role of Enhanced Recovery After Surgery (ERAS) protocols in head and neck surgery. Panelists will delve into evidence-based strategies that have reduced hospitalization lengths, opioid usage, and surgical complications while improving patient outcomes and satisfaction. Topics will include preoperative interventions (prehabilitation), such as malnutrition screening/nutritional optimization, tobacco cessation, and preoperative carbohydrate loading; intraoperative advancements like improved airway management, computer-assisted surgery (CAS), and fluid management/transfusion protocols; and postoperative strategies, including pain control, early mobilization, nutrition optimization and efficient discharge practices. Through systematic implementation of evidence-based practices, cost-savings of approximately $15,000-20,000 per patient is achievable – driven by improved efficiency, reduced operative times, shorter hospital stays, and better resource management.1,2

Attendees will gain insights into integrating ERAS protocols into clinical practice, via systems-based changes, and using technology for improved care delivery. By the end of the session, participants will have practical tools to implement these protocols effectively and contribute to better patient experiences/outcomes.

1) Yalamanchi P, Marentette LJ, Fendrick AM, Chinn SB, Prince MEP, Rosko AJ, Shuman AG, Spector ME, Stucken CL, Malloy KM, Casper KA. Application of Time-Driven Activity-Based Costing for Head and Neck Microvascular Free Flap Reconstruction. Otolaryngol Head Neck Surg. 2024 Jul;171(1):73-80. doi: 10.1002/ohn.739. Epub 2024 Apr 21. PMID: 38643408.

2) Fraser Hill WK, Redwood J, Thoma A, Hatchell A, Matthews J, David McKenzie C, Hart R, Chandarana SP, Wayne Matthews T, Dort JC, Schrag C. Millions Saved in Head and Neck Free Flap Reconstruction at a High-Volume Center: A Cost Analysis. Plast Surg (Oakv). 2024 Jan 22:22925503231225477. doi: 10.1177/22925503231225477. Epub ahead of print. PMID: 39553525; PMCID: PMC11561946.

OUTCOME OBJECTIVE 1: Explain key components of ERAS protocols in head and neck surgery.

OUTCOME OBJECTIVE 2: Evaluate strategies to enhance compliance with ERAS protocols across multidisciplinary teams.

OUTCOME OBJECTIVE 3: Implement evidence-based ERAS practices to optimize patient outcomes and reduce complications.

BACKGROUND STATEMENT:

Comprehensive Otolaryngology Track Statement : Head and neck cancer patients often face challenges like prolonged recovery, opioid reliance, and complications. This session addresses the clinical need for standardized, evidence-based ERAS protocols to improve outcomes and streamline perioperative care in this patient population.

Moderator(s)

SR

Scott A. Roof, MD

Assistant Professor
Mount Sinai
New York, NY, United States

Disclosure information not submitted.

Panelist(s)

EN

Elizabeth Nicolli, MD

University of Miami, United States

Disclosure information not submitted.
Matthew J. Mifsud, MD FACS

Associate Professor and Vice Chair
University of South Florida Department of Otolaryngology Head & Neck Surgery
Tampa, Florida, United States

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

Sid V. Puram, MD, PhD, FACS

Professor; Director of Head and Neck Tumor Center
Washington University in St Louis
St Louis, MO, United States

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