Head and Neck Cancer Reconstruction

Understanding Head and Neck Cancer

Head and neck cancer usually refers to cancers that arise from the mucosal surfaces of the upper aerodigestive tract, which includes the inside of the nose, mouth, throat, and voice box.  These areas of the body are critical for breathing, smell, taste, chewing, swallowing, and speaking.  Treatment of these cancers can involve surgery, chemotherapy, radiation therapy, or a combination of the three and can result in significant impairment of normal functioning and appearance.

Understanding the Surgery

Because the lips, mouth, tongue, throat, and voice box are so vital for normal everyday function and appearance, proper reconstruction is critical.  There are a number of methods your surgeon may use to perform your reconstruction following treatment for head and neck cancer.  Generally, surgeons follow a step wise methodology of reconstruction depending on the complexity of the defect following treatment.  The complexity of the reconstruction will often match the complexity of the defect.  For instance, when treating small cancers of the tongue, a majority of the normal tongue can often be preserved, making reconstruction relatively straightforward and possible by using suture techniques to recruit normal tongue tissue into the defect.  

However, if your cancer is more advanced, your surgeon may have to use tissues from elsewhere in the head and neck or even from close by areas of the body to reconstruct the defect.  These reconstructive methods are called local and regional flaps.  In some cases, bone is required to close the defect (such as in cancer involving the jaw).  Moreover, in some cases, use of local or regional flaps is not possible.  In these scenarios, your surgeon may use tissue from distant areas of the body to reconstruct the defect.  These situations require more advanced surgical techniques called micro-vascular free tissue transfer, which requires removing tissue from one part of the body (such as the leg, called the “donor site”) and transferring it to the head and neck for reconstruction.  In these surgeries, the artery and vein from the donor-site tissue has to be connected to a new artery and vein in the head and neck to help provide nourishment to the new tissue. 

What to Expect After Surgery

You may be admitted to the hospital following surgery for monitoring purposes and to help ensure that you are receiving an adequate amount of nutrition to heal properly.  More advanced reconstructive techniques, such as free flaps, generally require that patients remain in the hospital for several days following surgery.  

Reconstruction of head-and-neck cancer defects can be very challenging, but the evolution of surgical techniques and instrumentation has resulted in substantial improvements in patient outcomes, particularly with quality of life.  Selecting the proper facial plastic surgeon to perform your reconstructive procedure will help ensure an optimal outcome for you following cancer treatment.

Medical content written by the AAFPRS Multimedia Committee
Medical content reviewed/approved by Dr. Samuel M. Lam and Dr. Albert J. Fox