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Important Aspects of Head and Neck Reconstruction

Hanasono, Matthew M. M.D.; Matros, Evan M.D.; Disa, Joseph J. M.D.

Plastic and Reconstructive Surgery: December 2014 - Volume 134 - Issue 6 - p 968e–980e
doi: 10.1097/PRS.0000000000000722
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Learning Objectives: After studying this article, the participant should be able to: 1. Select appropriate local and pedicled flaps for oral cavity reconstruction based on the location and extent of the defect and donor-site characteristics. 2. Understand the functions of the tongue and select the appropriate reconstructive technique based on the size and location of the glossectomy defect. 3. Understand the advantages and disadvantages of treating various maxillectomy defects with prosthetics, soft-tissue pedicled and free flaps, and osteocutaneous free flaps. 4. Conceptualize a reconstructive algorithm for the hypopharynx based on the extent of circumference resected and need to replace external neck skin. 5. Understand advantages of the fibula over other osteocutaneous flaps for mandible reconstruction.

Summary: Head and neck defects are among the most challenging for the reconstructive surgeon because of the intimate relationship between form and function in this anatomical area. Microsurgical techniques have improved outcomes for these procedures by expanding the available reconstructive methods beyond the limitations of traditional pedicled flaps, although the pectoralis flap remains a useful workhorse option. This article reviews current surgical techniques for reconstruction of the oral cavity, maxilla, hypopharynx, and mandible in the cancer patient.

Related Video Content is available online.

Houston, Texas; and New York, N.Y.

From The University of Texas M. D. Anderson Cancer Center and Memorial Sloan-Kettering Cancer Center.

Received for publication May 20, 2013; accepted July 1, 2013.

Disclosure: The authors have no financial interest in any of the products or devices mentioned in this article.

Related Video content is available for this article. The videos can be found under the “Related Videos” section of the full-text article, or, for Ovid users, using the URL citations published in the article.

Joseph J. Disa, M.D., Division of Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, N.Y. 10065, disaj@mskcc.org

©2014American Society of Plastic Surgeons