Reconstruction Surgery or Plastic Surgery for Head and Neck Cancer Defects

Head and neck cancer surgery for advanced stage III and IV cancers can lead to devastating cosmetic and functional issues with resultant psychological, physical, and nutritional problems. Despite recent advances in medicine, the overall survival for patients with head and neck cancer has remained static for the past few decades. These result in significant impact on patient’s quality of life. Reconstruction of such defects continues to be an extremely demanding challenge for plastic surgeons who aim to restore form and function with minimal surgical morbidity. State-of-the-art reconstruction can help to minimize changes in your appearance caused by your cancer or your treatment and may also help in improving functions like speech, swallowing and breathing.

• Cancer surgeon and a reconstructive surgeon always work together during one operation to both remove your cancer and complete any reconstruction you need.
• The combined operation means you will have to be under anaesthesia for significantly less time than you would be for two separate operations.
• After surgery, a team of doctors, nurses, speech pathologists and physiotherapists will help you recover and rehabilitate.

Broadly reconstruction in head and neck region can be classified as follows

• Local Flaps -
  Local tissues are transferred into the defects resulting from cancer surgery. Commonly used local flaps are – Nasolabial flap , Submental flap , Forehead flap ,Scalp flap , Estlander flap
• Pedicled Flaps -
  Tissues from distant areas carrying their own blood supply are transferred into the defects resulting from cancer surgery. Pectoralis Major Muscle Myocutaneous flap is the most commonly used pedicled flap reconstruction for head and neck cancer defects.
• Free Flaps -
  Also called as microvascular free tissue transfer. Here tissue from other parts of body are taken with their vessels and transplanted into the surgical defects. It is equivalent to doing a transplant of one’s own tissues. Artery and veins from the flap are then anastomosed to vessels in the recipient site vessels. Few examples – Free radial artery forearm flap where tissue from forearm is used to reconstruction tongue or buccal mucosa defects. Free fibula osseocutaneous flap where fibula bone along with skin is taken and used to reconstruct segmental mandibular defects. Similarly, parts of the face, cheeks etc can be reconstructed using these complex reconstructive surgeries.

Tongue Reconstructed with Free Radial Artery Forearm Flap

Large Tongue Defect Reconstructed with Free Anterolateral Thigh Flap