Explore this issue:September 2013
Microvascular free tissue transfer for facial reconstruction, commonly known as free flaps, represents a clear advance in the reconstruction of large facial defects caused by head and neck tumors, trauma or congenital defects. Both cosmesis and function have greatly improved in patients who undergo this procedure, compared with prior treatments of these large defects that relied on suturing together tissues surrounding the defect, which left patients dealing with long-term cosmetic and functional complications.
One clear way to measure this advance is to examine patient outcomes in head and neck cancer patients. According to Daniel Alam, MD, head of the section of facial aesthetic and reconstructive surgery at the Head and Neck Institute Cleveland Clinic in Ohio, the data over the past 50 years on head and neck cancer show that, despite a lack of dramatic change in survival, patient outcomes and patient functional endpoints have improved dramatically from what they were 20 years ago. “A great part of that,” he said, “has been the improvement in how we do reconstruction.”