Current concepts in microvascular reconstruction.

摘要

Micro vascular head and neck reconstruction has become routine at most institutions over the past decade. Increased experience and volume of flaps has led to fewer complications, simplification of the algorithm for flap choice, and reduction of operative times. Significant advances in techniques have been made in midface reconstruction and anterior craniofacial resections that have led to improvement in outcomes. Addition of flaps of various tissue compositions and the re-evaluation of commonly used flaps for hypopharyngeal reconstruction have helped standardize our approach to these defects. Although complication rates and costs have been documented to suggest the superiority of free flaps, functional outcome data and quality of life measurements are still needed to clearly define the indications for free flaps in head and neck reconstruction. This article will describe advances in each of these areas.