Current reconstructive techniques following head and neck cancer resection using microvascular surgery.

Various techniques have been developed to reconstruct head and neck defects following surgery to restore function and cosmetics. Free tissue transfer using microvascular anastomosis has transformed surgical outcomes and the quality of life for head and neck cancer patients because this technique has made it possible for surgeons to perform more aggressive ablative surgery, but there is room for improvement to achieve a satisfactory survival rate. Reconstruction using the free tissue transfer technique is closely related to cardiovascular surgery because the anastomosis techniques used by head and neck surgeons are based on those of cardiovascular surgeons; thus, suggestions from cardiovascular surgeons might lead to further development of this field. The aim of this article is to present the recent general concepts of reconstruction procedures and our experiences of reconstructive surgeries of the oral cavity, mandible, maxilla, oropharynx and hypopharynx to help cardiovascular surgeons understand the reconstructions and share knowledge among themselves and with neck surgeons to develop future directions in head and neck reconstruction.

[1]  K. Blackwell,et al.  Quality of Life in Advanced Oropharyngeal Carcinoma After Chemoradiation Versus Surgery and Radiation , 2006, The Laryngoscope.

[2]  M. Morita,et al.  Comparison of salvage and planned pharyngolaryngectomy with jejunal transfer for hypopharyngeal carcinoma after chemoradiotherapy , 2010, The Laryngoscope.

[3]  D. Enepekides,et al.  The utility of microvascular anastomotic devices in head and neck reconstruction , 2008, Current opinion in otolaryngology & head and neck surgery.

[4]  Wei‐liang Chen,et al.  Extended supraclavicular fasciocutaneous island flap based on the transverse cervical artery for head and neck reconstruction after cancer ablation. , 2010, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[5]  S. Yoshimoto,et al.  Factors involved in free flap thrombosis after reconstructive surgery for head and neck cancer. , 2010, Auris, nasus, larynx.

[6]  A. Sabri.  Oropharyngeal reconstruction: current state of the art. , 2003, Current opinion in otolaryngology & head and neck surgery.

[7]  T. Takato,et al.  Evaluation of 15 mandibular reconstructions with Dumbach Titan Mesh-System and particulate cancellous bone and marrow harvested from bilateral posterior ilia. , 2009, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[8]  Tateyuki Iizuka,et al.  Fibula free flap reconstruction of the mandible in cancer patients: evaluation of a combined surgical and prosthodontic treatment concept. , 2008, Oral oncology.

[9]  E. Genden,et al.  Modern reconstruction techniques for oral and pharyngeal defects after tumor resection , 2007, European Archives of Oto-Rhino-Laryngology.

[10]  A. Menderes,et al.  A Comparison of Vascularized Fibular Flap and Iliac Crest Flap for Mandibular Reconstruction , 2008, The Journal of craniofacial surgery.

[11]  S. Yoshimoto,et al.  Analysis of 59 cases with free flap thrombosis after reconstructive surgery for head and neck cancer. , 2010, Auris, nasus, larynx.

[12]  T. Nakatsuka,et al.  Comparative evaluation in pharyngo-oesophageal reconstruction: radial forearm flap compared with jejunal flap. A 10-year experience. , 1998, Scandinavian journal of plastic and reconstructive surgery and hand surgery.

[13]  A. Eckardt,et al.  Microsurgical reconstruction in the head and neck region: an 18-year experience with 500 consecutive cases. , 2003, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[14]  M. Marunick,et al.  Midface reconstruction: Surgical reconstruction versus prosthesis , 2001, Head & neck.

[15]  S. Ebihara,et al.  Immediate maxillary reconstruction after malignant tumor extirpation. , 2007, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[16]  S. Ariyan.  The Pectoralis Major Myocutaneous Flap A Versatile Flap for Reconstruction in the Head and Neck , 1979, Plastic and reconstructive surgery.

[17]  Eun Chang Choi,et al.  Correlation of Neotongue Volume Changes With Functional Outcomes After Long-Term Follow-Up of Total Glossectomy , 2010, The Journal of craniofacial surgery.

[18]  K. Harii,et al.  Microvascular free skin flap transfer. , 1978, Clinics in plastic surgery.

[19]  N. Futran,et al.  Microvascular free flap reconstructive options in patients with partial and total maxillectomy defects. , 2000, Archives of facial plastic surgery.

[20]  O. Militsakh,et al.  Comparison of radial forearm with fibula and scapula osteocutaneous free flaps for oromandibular reconstruction. , 2005, Archives of otolaryngology--head & neck surgery.

[21]  P. Yu,et al.  Comparison of Clinical and Functional Outcomes and Hospital Costs following Pharyngoesophageal Reconstruction with the Anterolateral Thigh Free Flap versus the Jejunal Flap , 2006, Plastic and reconstructive surgery.

[22]  Xing Gao,et al.  Free Jejunal Graft for Reconstruction of Defects in the Hypopharynx and Cervical Esophagus Following the Cancer Resections , 2009, Journal of Gastrointestinal Surgery.

[23]  Dong-Il Sun,et al.  Risk factors of free flap compromise in 247 cases of microvascular head and neck reconstruction: a single surgeon’s experience , 2010, European Archives of Oto-Rhino-Laryngology.

[24]  Andrea Torroni,et al.  Scapula Free Flap for Complex Maxillofacial Reconstruction , 2009, The Journal of craniofacial surgery.

[25]  M. Granick,et al.  Reconstruction of complex maxillectomy defects with the scapular‐free flap , 1990, Head & neck.

[26]  H. Hoshikawa,et al.  Postoperative complications and long‐term prognosis of microsurgical reconstruction after total maxillectomy , 2006, Microsurgery.

[27]  Daniel Rk,et al.  Distant transfer of an island flap by microvascular anastomoses. A clinical technique. , 1973 .

[28]  M. Mauro,et al.  Nonoperative management of peripancreatic arterial aneurysms. A 10-year experience. , 1987, Annals of surgery.

[29]  J. Rieger,et al.  A longitudinal study of functional outcomes after surgical resection and microvascular reconstruction for oral cancer: tongue mobility and swallowing function. , 2010, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[30]  N. Futran,et al.  Developments in reconstruction of midface and maxilla. , 2006, The Lancet. Oncology.

[31]  A. Kunselman,et al.  A Prospective Study of Microvascular Free-Flap Surgery and Outcome , 1998 .

[32]  B. Seidenberg,et al.  Immediate reconstruction of the cervical esophagus by a revascularized isolated jejunal segment. , 1959, Annals of surgery.

[33]  T. Nakatsuka,et al.  Analytic review of 2372 free flap transfers for head and neck reconstruction following cancer resection. , 2003, Journal of reconstructive microsurgery.

[34]  N. Futran,et al.  Reconstruction of the midface and maxilla , 2010, Current opinion in otolaryngology & head and neck surgery.

[35]  J. Buatti,et al.  Long-term quality of life for surgical and nonsurgical treatment of head and neck cancer. , 2005, Archives of otolaryngology--head & neck surgery.

[36]  J. Bourhis,et al.  Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data , 2000, The Lancet.

[37]  F. Wei,et al.  Microsurgical free flap in head and neck reconstruction , 2010, Head & neck.