Patient-reported Outcome Measures in Head and Neck Reconstruction: A Systematic Review Across Disciplines and Geographical Locations.

[BACKGROUND] Patient-reported outcome measures (PROMs) have become an integral part of outcome evaluation in reconstructive microsurgery. This study explored the usage of PROMs in microsurgical oncological head and neck reconstruction across surgical specialties and geographic regions.

[METHODS] A systematic literature search was conducted in Embase, MEDLINE, and Web of Science to identify studies reporting on adult patients undergoing oncological head and neck free flap reconstruction. Data extracted included PROM tools used, study demographics, surgical disciplines involved, procedural details, and outcomes.

[RESULTS] Of 5015 screened studies, 354 (n = 30,369 patients) met the inclusion criteria. A total of 94 PROM tools were identified. The most frequently used were the University of Washington Quality of Life Questionnaire (34.75%), nonvalidated tools (25.99%), and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Head and Neck Module 35 (22.32%). Donor site-specific PROMs were infrequently used (22%), though more frequently used when plastic and reconstructive surgeons were involved (31.11% versus 15.53%, = 0.019). PROM selection varied significantly by specialty and geographic location, and only 20% of studies were interdisciplinary.

[CONCLUSIONS] Substantial heterogeneity exists in the use of PROMs in head and neck reconstruction, with variations driven by specialty and region. This lack of standardization hinders meaningful cross-study comparisons and the development of robust quality benchmarks. A unified, validated PROM framework is urgently needed to support international evidence-based practice. Future efforts should prioritize interdisciplinary collaboration and incorporate donor-site evaluation to comprehensively assess outcomes in oncological head and neck reconstruction.