Background The head and neck service at the Wellington Regional Plastics, Maxillofacial and Burns Unit at Hutt hospital, services central New Zealand with a catchment area of 1.2 million. The Head and Neck Database includes all patients undergoing major head and neck surgery. Data collected includes patient demographics, operations performed, tumour features and long-term survival data. We reviewed 25 years of data to provide insight into cases performed and trends, to plan future resource allocation.
Methods All patients on our Head and Neck Database between 1996 and 2021 were included. Patient demographics, gender, ethnicity, socio-economic status, source and reasons for referrals, and ablative and reconstructive procedures, were analysed.
Results A total of 1,747 patients with a median age of 68 years, underwent 2,004 operations, including 2,021 ablative and 1,062 reconstructive procedures. 66% of patients were male, 89% were NZ Europeans, and 50% of patients came from the most socio-economically deprived regions. 91% of referrals were head and neck cancer, with head and neck cutaneous squamous cell carcinoma (HNCSCC) and oral cavity squamous cell carcinoma (OCSCC) compromising 34% and 29% of head and neck cancer referrals, respectively. The annual number of operations performed increased from 5 to 106, and the number of free flap reconstructions, performed increased from 1 to 31 cases over this period.
Conclusion The majority of patients managed had head and neck cancer, mostly HNCSCC and OCSCC with increasing number of cases requiring free flap reconstruction. Based on the current trajectory, the number of major head and neck cases performed annually is likely to continue increasing. Most of the patients are from the most socioeconomically deprived regions of central New Zealand. These are important considerations when considering access to treatment, and planning future resource allocation for our service.