Ray Edward
Division of Plastic & Reconstructive Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Cancer Treat Res. 2018;174:123-143. doi: 10.1007/978-3-319-65421-8_8.
Head and neck reconstruction following surgical extirpative management of head and neck cancer requires critical assessment and meticulous correction of both aesthetic and functional deficits to optimize the physical and psychological well-being of the patient. Unique to head and neck cancers is the potential alteration of one's senses, breathing, speech, and swallowing functions, as well as overall head and neck aesthetics. When possible, tissue defects are replaced with similar tissues, though donor sites may be anatomically local, regional, or distant. The "reconstructive ladder" provides a heuristic approach to restoring the functional and aesthetic integrity of the head and neck cancer patient. Local tissue-rearrangement, grafts, flaps, and prosthetics are all options in the armamentarium of the reconstructive surgeon. The aim of this chapter is to familiarize the reader with the aims of reconstructive surgery, techniques employed to restore form and function as well as challenges and outcomes.
对头颈部癌症进行手术切除治疗后,头颈部重建需要对美学和功能缺陷进行严格评估并精心矫正,以优化患者的身心健康。头颈部癌症的独特之处在于,患者的感觉、呼吸、言语和吞咽功能以及整体头颈部美学可能会发生改变。在可能的情况下,组织缺损会用相似组织进行修复,尽管供区可能在解剖学上属于局部、区域或远处。“重建阶梯”为恢复头颈部癌症患者的功能和美学完整性提供了一种启发式方法。局部组织重排、移植、皮瓣和假体都是重建外科医生的可用手段。本章旨在使读者熟悉重建手术的目的、用于恢复形态和功能的技术以及挑战和结果。