Recent advances and controversies in head and neck reconstructive surgery
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Medknow Publications on behalf of Indian Journal of Plastic Surgery
Abstract
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Advances in head and neck reconstruction has made significant
improvement in the quality of life and resectability of head and neck
cancer. Refinements in microsurgical free tissue transfer leave made
restoration of form and complex functions of head and region a reality.
Standardized reconstructive algorithms for common head and neck defects
have been developed with predictable results. Some of the major
advances in the field include- sensate free tissue transfer, osseo
integrated implant and dental rehabilitation, motorized tissue transfer
and vascularized growth center transfer for pediatric mandible
reconstruction. However there exist several controversies in head and
neck reconstructive surgery. Some are old; resolved partially in the
light of recent clinical evidences and others are new, developed as a
result of newly introduced reconstructive techniques. These include,
primary versus secondary reconstruction, pedicled versus free flaps,
primary closure versus free tissue transfer for partial glossectomy
defects, reconstruction of posterior mandible and reconstruction of
orbital exenteration defects. Rapid advances in the field of tissue
engineering and stem cell research is expected to make radical change
in the field of reconstructive surgery. This manuscript review progress
in head and neck reconstructive surgery during the last decade, current
controversies and outline a road map for the future.
Keywords
tissue engineering, reconstruction, head and neck, Free tissue transfer
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