1. The International Federation
of Head and Neck Oncologic Societies
Current Concepts in Head and Neck Surgery and Oncology 2012
Reconstructive Techniques
in
Head and Neck Surgery
Jatin P. Shah

2. Impact of Cancer Ablative
Surgery of the Oral Cavity
Aesthetic
Aesthetic Functional
Functional
Contour
Contour Speech
Speech
Expression
Expression Mastication
Mastication
Competence
Competence Swallowing
Swallowing
Oral Cripple
Oral Cripple
2012

3. Extent of Tissue Loss from
Cancer Ablative Surgery of the
Oral Cavity
Soft Tissue
Soft Tissue Bone
Bone
Mobile
Mobile
Mobile Immobile
Immobile
Mobile
2012

4. 2012

5. Reconstruction of Oral Cavity Goals
Functional:
• Oral Competence
• Clarity of speech
• Tongue Mobility
• Mastication
• Bolus Transport
• Regurgitation
• Aspiration
• Tactile Sensations
• Taste
2012

6. Reconstruction of Oral Cavity Goals
Aesthetics:
• Bony Framework
• Soft Tissue Contour
• Chin Protrusion
• Mobility
• Oral Competence
2012
• Skin Sensation

7. Oral Cavity
Soft Tissue Loss
• Mucosa
• Mucosa + submucosal soft tissue
• Mucosa + soft tissue + muscles
• Mucosa + soft tissue + muscles + skin
• Mucosa + soft tissue + muscles + bone
2012

8. Oral Cavity
Bone Loss
Maxilla Mandible
• Partial Hard Palate • Marginal
• Total Hard Palate Mandibulectomy
• Upper and Lower • Ascending Ramus
Gum Resection • Short Segment of Body
• Hemimandibulectomy
• Anterior Arch Resection
2012

9. Soft Tissue Reconstruction of Oral Cavity
Mucosa
• None
• Split Skin Graft
• Primary Closure
2012

10. Soft Tissue Reconstruction of Oral Cavity
Mucosa and Submucosal Soft Tissue
• Skin Graft
• Primary Closure
• Local Flap
2012

11. Skin Graft in
Floor of Mouth
2012

12. Soft Tissue Reconstruction of Oral Cavity
Mucosa, Soft Tissue & Muscles
• Skin Graft
• Primary Closure
• Local Flap
• Regional Cutaneous Flap
• Myocutaneous Flap
2012
• Radial Forearm Free Flap

13. Reconstruction of the Face and
Neck
• Local Flaps
• Regional Cutaneous Flaps
• Regional Myocutaneous Flaps
• Free Flaps
Radial Forearm,
Anterolateral thigh,
2012
Rectus Abdominis,
Latissimus Dorsi etc.

14. Cervical Flap for Parotid Defect
2012

15. Cervical Flap for Neck Defect
2012

16. Delto Pectoral Flap
2012

17. Pectoralis Myocutaneous Flap
2012

18. PMMC Flap with Brachytherapy
2012

19. Vertical Trapezius MC Flap
2012

20. Microvascular Free Flaps
in Head and Neck Reconstruction
• Radial forearm
• Anterolateral thigh
• Latissimus Dorsi
• Rectus abdominis
• Fibula
2012
• Jejunum

21. Radial Forearm Free Flap
2012

22. RFFF for Facial defects
2012

23. RFFF for Oral Defects
2012

24. Rectus Abdominis Free Flap
2012

25. Bone Reconstruction of Oral Cavity
Upper Alveolus (Palatal)
• None (prosthesis)
• Microvascular Free Flap
2012

26. Dental Prosthesis for palatal Defect
2012

27. Mandibular Defects
2012

28. Bone Reconstruction of Oral Cavity
Ascending Ramus of the Mandible
• None
• A.O. Plate
• Microvascular Free Flap
2012

29. Bone Reconstruction of Oral Cavity
Body of the Mandible
• None
• A.O. Plate
• Free non-vascularized graft
(short segment)
2012
• Microvascular free flap

30. Bone Reconstruction of Oral Cavity
Anterior Arch of the Mandible
• None
• Microvascular free flap
2012

31. Radial Forearm
Osteocutaneous Flap
2012

32. Fibula Free Flap
2012

33. Fibula Free Flap for Tongue
and Mandible Reconstruction
2012

34. Fibula Free Flap for Anteriror
Arch of Mandible
2012

35. Dental Implants in Fibula Free Flap
2012