Head and neck reconstruction

What is head and neck cancer?

Head and neck cancers may be found inside your nose, throat, mouth, larynx (voice box) or lips, including near or in your nasal cavity or salivary glands. These cancers tend to start in the squamous cells that line the surfaces of your head and neck.

If you’ve been treated for head or neck cancer, your doctor may recommend reconstructive surgery to improve the cosmetic and/or functional outcomes of certain procedures.

Removing cancer in or around your cheeks, for example, may leave a gap that can be disfiguring and serve as a constant reminder of your diagnosis. Through advances in technology and techniques, reconstructive surgery can help fill the cheek area, improving its look and aiding your emotional recovery. Or if surgical treatment of tongue cancer makes it hard to swallow afterward, rebuilding your tongue can help restore this function.

Reconstructive surgery: What to know

Reconstructive surgery—typically performed by a reconstructive/plastic surgeon or an oral and maxillofacial surgeon—can make a big difference in your appearance and improve a function that was lost or compromised by cancer treatment. Other experts may also be involved in the process based on the type of surgery or surgeries being performed. If you’re getting dental implants, for example, a team consisting of a dentist, oral surgeon, periodontist, prosthodontist and/or endodontist may be needed.

There are many types and combinations of reconstructive surgeries based on the cancer’s location, extent and treatment. Sometimes, more than one operation is necessary to achieve the desired results.

In general, your surgeon may use skin, bone, muscle, tissue, nerve grafts or implants to correct any issues. Such grafts can be taken from other parts of your body or from a donor, and some can be man-made.

Reconstructive techniques

Below is a list of some reconstructive techniques used after head and neck cancer treatment.

Reconstructive options for throat cancers

Free flap reconstruction: This procedure involves taking tissue from one part of your body—usually farther away from the treated area, such as a piece of intestine or arm muscle—and transplanting it to the throat. The tissue may be muscle, bone, skin, nerves or a combination, depending on what is being reconstructed. For it to be successful, your surgeon must also transfer blood vessels to establish a new blood supply to the transplanted flaps so that they can survive.

Local flap reconstruction, or myocutaneous flaps: Your surgeon moves tissue from one part of your body (the donor site) to the surgical site (the recipient site). The tissue is usually taken from a neighboring location, which means it can be adjusted to cover the affected area, and comes with its own blood flow. A surgeon may partially detach a muscle in your chest (or another muscle near the throat), along with a piece of adjoining skin, and then flip it over the affected area.

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