(A640) The Impact of the COVID-19 Pandemic on Head and Neck Microvascular Reconstruction Outcomes

Monday, October 13, 2025

12:00 PM - 1:00 PM EDT

Location: OTO EXPO, Posters

Presenting Author(s)

Christine Lee, BA, MPH

Medical Student
University of Cincinnati College of Medicine
Cincinnati, Ohio, United States

Co-Author(s)

Emma Nienaber, BS

Medical Student
University of Cincinnati College of Medicine
Erlanger, Kentucky, United States
Adam Beucler, BS

Medical Student
University of Cincinnati College of Medicine
Hudson, Ohio, United States
EW

Eric Wong, BS

Medical Student
University of Cincinnati College of Medicine, United States
ST

Siddhant Tripathi, MD

Resident Physician
University of Cincinnati College of Medicine, United States
AK

Alexander Karabachev, MD

Resident Physician
University of Cincinnati College of Medicine, United States
JB

Josiah Brandt, MD

Resident Physician
University of Cincinnati College of Medicine, United States
Grace Zhang, MD

Resident Physician
Icahn School of Medicine at Mount Sinai
Carmel, Indiana, United States
JG

Jack Garcia, BS

Medical Student
University of Cincinnati College of Medicine, United States
NH

Nicholas Hutchins, BS

Medical Student
University of Cincinnati College of Medicine, United States
AH

Abigail Haslinger, BS

Medical Student
University of Cincinnati College of Medicine, United States

Senior Author(s)

YP

Yash Patil, MD

Physician
University of Cincinnati College of Medicine, United States

Disclosure(s):

Christine Lee, BA, MPH: No relevant relationships to disclose.

Emma Nienaber, BS: No relevant relationships to disclose.

Adam Beucler, BS: No relevant relationships to disclose.

Grace Zhang, MD: No relevant relationships to disclose.

Introduction: This retrospective cohort study sought to explore the impacts of the COVID-19 pandemic and associated changes in operative practices on head and neck microvascular reconstruction outcomes.

Methods: Demographic and clinical data were collected from patients who underwent head and neck microvascular reconstruction at the University of Cincinnati Medical Center by a single surgeon between 2018 and 2021. Patients with operations in 2018-2019 constituted the pre-pandemic cohort, and patients with operations in 2020-2021 constituted the pandemic cohort.
Univariate analysis was performed to compare pandemic and pre-pandemic cohorts. Poisson regression analysis was used to assess the association of operations during the pandemic with our primary outcomes. Primary outcomes included length of hospital stay, 30-day readmission, 2-year post-operative survival, wound infection, fistula formation, and 2-year cancer recurrence. Peri-operative practices analyzed included neck dissection, PEG tube placement, tracheostomy, and post-operative radiation therapy. Regression analyses were controlled for covariates.

Results: 220 patients met the inclusion criteria for this study, with 117 in the pre-pandemic cohort and 103 in the pandemic cohort. Post-operative wound infections were significantly more common during the pandemic than before (RR=4.36; 95% CI= [0.99, 30.32]) whereas 2-year cancer recurrence decreased (RR=0.52; 95% CI= [0.34, 0.80]). All other surgical outcomes were not significantly different between cohorts.
Tracheostomy (RR=0.55; 95% CI= [0.34, 0.86]), PEG tube placement (RR=0.26; 95% CI= [0.08, 0.69]), and neck dissection (RR=0.97; 95% CI=[0.68, 1.38]) were less frequently performed in operations during the pandemic. Similarly, post-operative radiation therapy was less common during the pandemic (RR=0.65; 95% CI=[0.39, 1.06]).

Conclusions: These findings suggest notable practice shifts affecting head and neck microvascular reconstruction outcomes during the COVID-19 pandemic, including increased wound infection but decreased recurrence of cancer.