Microvascular Reconstructive Surgery
- When patients have cancers that are large or advanced, our specialists perform complicated surgeries to remove tumors from the jaw and face. Our hospital has the only team of microvascular surgeons in the region who are experienced in head and neck reconstruction. Their goal is helping patients heal as fully as possible, because they understand the importance of preserving a patient's appearance and function level.
- If the oral cavity tumor arises in the oral lining covering the lower jaw, there is a very high risk that cancer has invaded the bone, especially if the patient has no teeth. In this situation, part of the jaw bone needs to be removed with the tumor. In the past, this defect was either left to scar down or it was reconstructed at best with a metal plate or a plate plus some bone grafts taken from the pelvic bone. These grafts would break down, leaving patients with severe pain, disfigurement and inability to speak clearly or eat solid food.
- This has changed remarkably in the last 2 decades with the era of microvascular or free flap reconstruction. This is a technique in which skin, soft tissue, muscle or bone may be taken from various areas of the body, together with their own artery that can bring blood into the tissue and vein that can drain the blood from the tissues. Upper and lower back, forearm, lower leg, thigh, abdomen or even bowel can provide donor tissue.
- When a free flap is obtained from a leg, a fragment of the fibula or a lower leg bone is cut into pieces, and the pieces are plated together with titanium plates, recreating the contour of the missing jaw. Often there is skin to recreate lining of the mouth, and of course, the artery and the vein. The vessels are sutured under the microscope, using fine nylon sutures, to the vessels in the patient's neck. The blood starts flowing into the flap, giving it life. This is similar to transplant surgery, except the donor tissue is taken from the patient rather than another person.
Advantages of the Microvascular Reconstruction in the Head and Neck:
- Allows to remove tumors previously considered inoperable
- Better speech and swallowing: quality of life issues
- Significant cosmetic improvement
- Brings healthy tissue to poor-healing wounds after radiation
Oct 28, 2013