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Head and Neck Reconstructive Surgery

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Part of the book series: Cancer Treatment and Research ((CTAR,volume 174))

Abstract

Head and neck reconstruction following surgical extirpative management of head and neck cancer requires critical assessment and meticulous correction of both aesthetic and functional deficits to optimize the physical and psychological well-being of the patient. Unique to head and neck cancers is the potential alteration of one’s senses, breathing, speech, and swallowing functions, as well as overall head and neck aesthetics. When possible, tissue defects are replaced with similar tissues, though donor sites may be anatomically local, regional, or distant. The “reconstructive ladder” provides a heuristic approach to restoring the functional and aesthetic integrity of the head and neck cancer patient. Local tissue-rearrangement, grafts, flaps, and prosthetics are all options in the armamentarium of the reconstructive surgeon. The aim of this chapter is to familiarize the reader with the aims of reconstructive surgery, techniques employed to restore form and function as well as challenges and outcomes.

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References

  1. Golas AR, Levine JP, Ream J et al (2016) Aberrant lower extremity arterial anatomy in microvascular free fibula flap candidates. J Craniofac Surg 27(8):2134–2137

    Article  PubMed  Google Scholar 

  2. Ellis DS, Stewart WB, Toth BA (1991) Orbital exenteration. The reconstructive ladder. Ophthal Plast Reconstr Surg 7(2):84–93

    Article  PubMed  Google Scholar 

  3. Garrett GL, Beegun I, D’Souza A (2015) Facial transplantation: historical developments and future directions. J Laryngol Otol 129(3):206–211

    Article  CAS  PubMed  Google Scholar 

  4. Sinna R, Boloorchi A, Mahajan AL et al (2010) What should define a “perforator flap”? Plast Reconstr Surg 126(6):2258–2263

    Article  CAS  PubMed  Google Scholar 

  5. Menick FJ (2016) Principles and planning in nasal and facial reconstruction: making a normal face. Plast Reconstr Surg 137(6):1033e–1047e

    Article  CAS  PubMed  Google Scholar 

  6. McGregor IA, Morgan G (1973) Axial and random pattern flaps. Br J Plast Surg 26(3):202–213

    Article  CAS  PubMed  Google Scholar 

  7. Sakamoto Y, Takahara T, Ota Y et al (2014) MRI analysis of chronological changes in free-flap volume in head and neck reconstruction by volumetry. Tokai J Exp Clin Med 39(1):44–50

    PubMed  Google Scholar 

  8. Desai SC, Sand JP, Sharon JD et al (2015) Scalp reconstruction: an algorithmic approach and systematic review. JAMA Facial Plast Surg 17(1):56–66

    Article  PubMed  Google Scholar 

  9. Richardson MA, Lange JP, Jordan JR (2016) Reconstruction of full-thickness scalp defects using a dermal regeneration template. JAMA Facial Plast Surg 18(1):62–67

    Article  PubMed  Google Scholar 

  10. McLean DH, Buncke HJ Jr (1972) Autotransplant of omentum to a large scalp defect, with microsurgical revascularization. Plast Reconstr Surg 49(3):268–274

    Article  CAS  PubMed  Google Scholar 

  11. Lamaris GA, Knackstedt R, Couto RA et al (2017) The anterolateral thigh flap as the flap of choice for scalp reconstruction. J Craniofac Surg 28(2):472–476

    Article  PubMed  Google Scholar 

  12. Cordeiro PG, Chen CM (2012) A 15-year review of midface reconstruction after total and subtotal maxillectomy: part I Algorithm and outcomes. Plast Reconstr Surg 129(1):124–136

    Article  CAS  PubMed  Google Scholar 

  13. Lee T, Chung C, Chang Y et al (2015) Comparison of clinical and functional outcomes using pectoralis major and cutaneous free flaps for hypopharyngeal squamous cell carcinoma. Arch Plast Surg 42(5):608–613

    Article  PubMed  PubMed Central  Google Scholar 

  14. Shenoy A, Patil VS, Prithvi BS et al (2013) Supraclavicular artery flap for head and neck oncologic reconstruction: an emerging alternative. Int J Surg Oncol 2013:658–989. https://doi.org/10.1155/2013/658989

    Google Scholar 

  15. Cordeiro PG, Disa JJ, Hidalgo DA et al (1999) Reconstruction of the mandible with osseous free flaps: a 10-year experience with 150 consecutive patients. Plast Reconstr Surg 104(5):1314–1320

    Article  CAS  PubMed  Google Scholar 

  16. Brown JS, Lowe D, Kanatas A et al (2017) Mandibular reconstruction with vascularised bone flaps: a systematic review over 25 years. Br J Oral Maxillofac Surg 55(2):113–126

    Article  CAS  PubMed  Google Scholar 

  17. Vashistha A, Singh M, Chaudhary M et al (2017) Comparison of 2 mm single locking miniplates versus 2 mm two non-locking miniplates in symphysis and parasymphysis fracture of mandible. J Oral Biol Craniofac Res 7(1):42–48

    Article  PubMed  Google Scholar 

  18. Bell RB, Wilson DM (2008) Is the use of arch bars or interdental wire fixation necessary for successful outcomes in the open reduction and internal fixation of mandibular angle fractures? J Oral Maxillofac Surg 66(10):2116–2122

    Article  PubMed  Google Scholar 

  19. Kniha K, Mohlhenrich SC, Foldenauer AC et al (2017) Evaluation of bone resorption in fibula and deep circumflex iliac artery flaps following dental implantation: a three-year follow-up study. J Craniomaxillofac Surg 45(4):474–478

    Article  PubMed  Google Scholar 

  20. Born G (1999) Modified Antia-buch repair for full-thickness upper pole auricular defects. Plast Reconstr Surg 104(7):2332–2333

    Article  CAS  PubMed  Google Scholar 

  21. Zhu J, Zhao H, Wu K et al (2016) Reconstruction of auricular conchal defects with local flaps. Medicine (Baltimore) 95(46):e5282. https://doi.org/10.1097/md.0000000000005282

  22. Hamzavi S (2015) Porous polyethylene implant and rib cartilage in ear reconstruction: a comparison. Facial Plast Surg 31(6):611–616

    Article  CAS  PubMed  Google Scholar 

  23. Menick FJ, Salibian A (2011) Microvascular repair of heminasal, subtotal, and total nasal defects with a folded radial forearm flap and a full-thickness forehead flap. Plast Reconstr Surg 127(2):637–651

    Article  CAS  PubMed  Google Scholar 

  24. Graboyes EM, Garrett-Mayer E, Sharma AK et al (2017) Adherence to national comprehensive cancer network guidelines for time to initiation of postoperative radiation therapy for patients with head and neck cancer. Cancer. https://doi.org/10.1002/cncr.30651

    Google Scholar 

  25. Sun AH, Xu X, Sasaki CT et al (2017) A thirty-year experience with head and neck flap reconstruction. J Craniofac Surg. https://doi.org/10.1097/SCS.0000000000003591

    Google Scholar 

  26. Cannady SB, Hatten K, Wax MK (2016) Postoperative controversies in the management of free flap surgery in the head and neck. Facial Plast Surg Clin North Am 24(3):309–314

    Article  PubMed  Google Scholar 

  27. Murphy J, Isaiah A, Dyalram D et al (2017) Surgical site infections in patients receiving osteomyocutaneous free flaps to the head and neck. Does choice of antibiotic prophylaxis matter? J Oral Maxillofac Surg. https://doi.org/10.1016/j.joms.2017.02.006

  28. Novakovic D, Patel RS, Goldstein DP et al (2009) Salvage of failed free flaps used in head and neck reconstruction. Head Neck Oncol 1:33–37. https://doi.org/10.1186/1758-3284-1-33

    Article  PubMed  PubMed Central  Google Scholar 

  29. Nishikawa H, Manek S, Barnett SS, Charlett A, Green CJ (1993) Pathology of warm ischaemia and reperfusion injury in adipomusculocutaneous flaps. Int J Exp Pathol 74(1):35–44

    CAS  PubMed  PubMed Central  Google Scholar 

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Correspondence to Edward Ray .

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Ray, E. (2018). Head and Neck Reconstructive Surgery. In: Maghami, E., Ho, A. (eds) Multidisciplinary Care of the Head and Neck Cancer Patient. Cancer Treatment and Research, vol 174. Springer, Cham. https://doi.org/10.1007/978-3-319-65421-8_8

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  • DOI: https://doi.org/10.1007/978-3-319-65421-8_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-65420-1

  • Online ISBN: 978-3-319-65421-8

  • eBook Packages: MedicineMedicine (R0)

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