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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