Head and Neck Reconstruction

Reconstruction of head and neck wounds due to surgical resection for cancer or head and neck trauma creates numerous challenges for the microsurgeon.  Defects are both functional and cosmetic, defying the reconstructive surgeon to minimize any loss in speech or oromotor capacity while maintaining a normal appearance.  Advances in microsurgical transplantation have improved reconstructive efforts considerably from a time when reconstruction meant only filling a defect.

The complex anatomy of the head and neck area creates numerous functional mechanisms involved in: 

• Speech

• Swallowing

• Sensation

• Oral continence

• Airway protection

• Facial expression 

The goal of reconstruction is to preserve and protect all these mechanisms as much as possible while obtaining reasonalbe restoration of function and reconstruction of form.  This must frequently be done in conjunction with a cancer surgeon who must attempt to achieve an ablative cure.  Using microsurgical reconstruction,  resection of tumor can often be even more aggressive since repair of even large defects is possible.  Many patients with head and neck cancer require radiation treatment or chemotherapy, aumenting the need for a well vascularized tissue reconstruction.  Althogh numerous factors are involved in the selection of a reconstruction, microvascular transplantation often results in the most consistent and rewarding reconstruction.