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Microvascular Free-Flap Reconstruction in the Head and Neck

Neal D. Futran, MD, DMD; Ramsey Alsarraf, MD, MPH
JAMA. 2000;284(14):1761-1763. doi:10.1001/jama.284.14.1761.
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Most cancerous tumors of the head and neck cannot be adequately treated without surgical excision. Although tumor extirpation often results in better disease control and prolonged survival, patients may be left with devastating functional and cosmetic defects. Traumatic facial injuries can be similarly disfiguring, and may also limit speaking and swallowing function. In the last century, the aim of reconstructive techniques in the head and neck has evolved from the mere filling of a defect to the reestablishment of the patient's original appearance and function. Although the goal of modern surgical reconstruction is to obtain normal oromotor and other facial functions, as well as a personally and socially acceptable cosmetic result, the complex anatomy of the face and mouth presents unique technical challenges. The development of microvascular free-tissue transfer during the last 2 decades has provided a set of techniques to overcome these difficult problems.

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Figure 1. Soft Tissue Reconstruction of the Oral Cavity
Graphic Jump Location
Repair of hemitongue defect with radial forearm fasciocutaneous flap.
Figure 2. Oromandibular Reconstruction
Graphic Jump Location
Postoperative panorex x-ray film following fibula osseocutaneous free-flap reconstruction with primary dental implants.



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