Head and neck cancer surgery II: Reconstruction

Patients presenting for head and neck cancer resections may eventually require surgical reconstruction to fix anatomic defects and maintain aerodigestive and masseter function. Complex head and neck reconstructive surgery represents a unique interaction between the reconstructive surgeon and the anesthesiologist. The management of head and neck pathology including trauma, congenital deformities, as well as benign and malignant tumors requires a substantial array of reconstructive techniques. Over the last several decades the most significant reconstructive advancement from the surgical standpoint is the technique of free tissue transfer, the so-called free flap. This procedure involves harvesting distant tissues and transferring reconstructive elements such as bone, soft tissue, and muscle to ablative defects of the head and neck (see Fig. 16.1).