Hurvitz Keith A, Kobayashi Mark, Evans Gregory R D
Orange, Calif. From the Aesthetic and Plastic Surgery Institute, University of California Irvine Medical Center.
Plast Reconstr Surg. 2006 Oct;118(5):122e-133e. doi: 10.1097/01.prs.0000237094.58891.fb.
After studying this article, the participant should be able to: 1. Understand current trends in the treatment of head and neck cancer. 2. Discuss the challenges of reconstructing head and neck defects 3. Understand the different reconstructive options available for specific anatomical regions of the head and neck.
Reconstructive surgery of the head and neck is both technically challenging and rewarding. In the past 20 years, significant advances in this field have improved surgical outcomes and patient function. The development and subsequent refinement of microvascular techniques, in particular, have been a major reason for this progression.
In this article, the authors review the current options available in head and neck reconstruction. Because a large number of major craniocervicofacial defects result from oncologic resection, the authors have focused their review on this particular subject. By dividing their discussion into different anatomical sites, the authors hope to cover all major aspects of this broad topic.
Free tissue transfer has revolutionized head and neck reconstruction. The most widely used free flaps include the fibula, radial forearm, anterolateral thigh, and rectus abdominis. Restoration of both form and function is the ultimate goal.
Although defects of the head and neck region present a challenge, successful cosmetic and functional results have been achieved with both local and free tissue flaps. The flexibility of free tissue transfer, however, has dominated this area and continues to be the method of choice for reconstruction of sizable defects.
在学习本文后，参与者应能够：1. 了解头颈部癌症治疗的当前趋势。2. 讨论头颈部缺损重建的挑战。3. 了解头颈部特定解剖区域可用的不同重建选择。
头颈部重建手术在技术上既具有挑战性又富有成效。在过去20年中，该领域的重大进展改善了手术效果和患者功能。特别是微血管技术的发展及随后的完善，是这一进展的主要原因。
在本文中，作者回顾了头颈部重建的当前可用选择。由于大量主要的颅颈面部缺损是由肿瘤切除引起的，作者将其综述重点放在了这个特定主题上。通过将讨论分为不同的解剖部位，作者希望涵盖这个广泛主题的所有主要方面。
游离组织移植彻底改变了头颈部重建。最广泛使用的游离皮瓣包括腓骨、桡侧前臂、股前外侧和腹直肌。恢复形态和功能是最终目标。
尽管头颈部区域的缺损带来了挑战，但使用局部和游离组织皮瓣均已取得了成功的美容和功能效果。然而，游离组织移植的灵活性在该领域占据主导地位，并且仍然是重建大面积缺损的首选方法。
