Past, Present and Future directions and Rational Approach in Reconstruction of Head and Neck Cancer

Head and neck cancer as well as other tumors is increasing its incidence all over the world; This growth probably may be due to a better life expectancy and its subsequent aging which favors the appearance of tumors in the elderly, due to environmental or carcinogenic exposition and in young people to the increase of HPV related cancer. In developing countries, unlike their counterpart head and neck cancer is diagnosed in more advanced stages. In early stages treatment usually requires a unique modality of treatment, whatever surgery or radiation entails excellent results in terms of survival and quality of life, but in advanced stages, head and neck cancer itself outcomes in a devastating tumor that affects function and esthetics, sometimes with a bulky deforming tumor along with pain, necrosis and bad smelling infection that isolates the patient even from his own family. Additionally, in this stage treatment requires combination of at least two modalities, like surgery and radiation, or chemotherapy and radiation, and often the combination of the three of them. Surgery effects and toxicity of chemoradiation affects function and esthetics and of course impacts quality of life. Reconstruction when necessary, is vital in promoting tissues to achieve a proper scarring while interposing healthy tissue. It also speeds up an earlier start of adjutancy. But maybe the main goal of reconstruction is to improve rehabilitation, function, esthetics, and quality of life. Many decades ago, after tumor resection with ignorance of technics in reconstruction patients coexisted with mutilating surgeries that while controlling cancer left behind devastated human beings condemned to isolation. For more than a century reconstruction has been developing, trying to achieve better results, starting from ingenious techniques just to simply cover a surgical defect, going to techniques that allowed to rotate nearby tissues based on a vascular pedicle that keeps tissue vital up to transplant a new and healthy tissue from distant places of the body economy. Now a day’s, In the millennium of technologies and associated with this growth, microvascular free flaps are planned and design with three-dimensional models that enhances the functional results. by implanting a more precise tissue specially when an osteocutaneous reconstruction is necessary.

Author(s): Chala Andres

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