Head and Neck Reconstruction in Trauma and Cancer

Abstract

It is challenging to perform reconstruction for head and neck regions following trauma or cancer ablation even today. Although microsurgery has improved greatly in the past 50 years, there are still many problems when the defect is large because of the complex functions of the head and neck and the increasing expectation on the part of the patients. Notable advances in head and neck reconstruction include (1) improvement in flap survival and decreased morbidity of both donor sites and recipient sites, (2) capacity of reconstruction for complex defects, (3) improvement in functions through intimate cooperation among ENT, neurosurgery, dentistry, and plastic surgery, (4) improvement in aesthetic result especially in facial reconstruction, (5) application to new fields such as tracheal reconstruction and voice reconstruction with a segment of jejunum or ileocolon, (6) creation of new flaps, and (7) tissue engineering and transplantation, which are still under investigation. The results of free flaps have been more and more controllable. Treatment has become centered on the patient and his disease instead of a flap-oriented approach. For head and neck reconstruction free flaps have been used in critical areas such as the skull base. They will be even more widely used in the future. Longer survival after cancer ablation and reconstruction is also contributed to by improved chemotherapy, radiotherapy, and other specialties.