Advances in Head and Neck Reconstruction

Learning Objectives: After studying this article, the participant should be able to determine: 1. Trends in the oncologic management of head and neck cancer. 2. The functional and aesthetic goals for reconstruction in patients with head and neck malignancies. 3. Common reconstructive techniques and appropriate planning for specific defects and anatomic locations. 4. Current limitations in the various reconstructive options with respect to functional and aesthetic restoration. 5. Future areas for improvement in the functional and aesthetic outcome after head and neck reconstruction. Head and neck deformities, which can be caused by trauma, congenital defects, infections, or neoplasms, produce a stereotypical constellation of functional and aesthetic deficits, depending on the specific anatomic region. These deformities can be classified into six major anatomic categories: intraoral, mandibular, midfacial, cranial base, cutaneous, and scalp. This article presents a reliable approach to the reconstruction of these six areas that is used at the University of Texas M. D. Anderson Cancer Center. The emphasis is on an analysis of the unique functional and aesthetic problems presented by each of these specific anatomic lesions, and the reconstructive options are selected to maximize outcomes. The problems and limitations of current methods are discussed, and areas of potential development are explored. (Plast. Reconstr. Surg. 106: 672, 2000.)