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Healthcare: Cancer Care

Reconstructive Surgery

Master
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Reconstructive Head and Neck Surgery

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In the surgical treatment of head and neck cancers, oftentimes the removal of cosmetically and/or functionally important structures is integral in achieving cure. These structures can include the mandible (lower jaw bone), maxilla (upper jaw bone), larynx (voice box), pharynx (throat), facial nerve, base of the skull, and skin. When removed, patients may not only be left with disfiguring wounds, but also with impairments in swallowing, speaking and even breathing. These negative impacts on quality of life, not to mention survival, make prompt and complete reconstruction of the utmost importance.

Microsurgical reconstruction of the head and neck has made the operative management of advanced head and neck cancers a mainstay of therapy. In these procedures, the tissues (for example bone, muscle, nerve, skin) removed in cancer surgery are systematically reconstructed and replaced by similar tissues taken from a distant site of the body by means of transplantation. As an example, fibula bone and skin can be harvested and used to replace the bone of the maxilla or mandible, as well as the lining of the mouth, giving patients both excellent functional and cosmetic outcomes.

These composite tissue transplantations are called microvascular free tissue transfers and require harvesting of the reconstructive tissues with their associated blood supply. The blood vessels, on average only one to three millimeters in diameter, are then sutured with the aid of a microscope to an artery and vein near the cancer defect so that the transplanted tissue can survive in its new environment. Similarly, nerves can also be reconstructed with these microsurgical techniques providing means for patients to regain either sensory or motor function lost in their cancer removal surgery.

The team at Baylor Medicine is experienced in microsurgical reconstruction, having done hundreds of procedures, and are at the forefront of advanced techniques including computer-aided design/computer-aided manufacturing (CAD/CAM), perforator flap harvest, supermicrosurgical lymphedema treatments, and the use of near-infrared vascular imaging. To contact us for a consultation regarding your reconstructive needs, please call (713) 798-5900.