Reconstruction After Head and Neck Cancer
Microvascular Reconstruction Surgery
Surgeons at Froedtert & the Medical College of Wisconsin are uniquely qualified to offer an innovative team approach to certain head and neck cancer surgeries. Microvascular reconstruction surgery is a complex approach to reconstructing certain structures after surgery to remove various head and neck tumors. Bruce Campbell, MD, and Becky Massey, MD, Medical College of Wisconsin head and neck cancer surgeons, work together on these advanced procedures.
Dr. Campbell performs the surgery to remove the tumor while Dr. Massey removes tissue from another area of the body to repair the site where the tumor was removed. It’s all done at the same time to decrease the time the patient is under general anesthesia and make it easier on the patient. For example, if part of a patient’s jaw bone is removed by Dr. Campbell, Dr. Massey might remove part of the patient’s fibula to construct a new mandible or jaw bone. In other cases, part of the patient’s forearm or thigh might be removed to rebuild the part of the patient’s tongue, larynx or pharynx that was removed.
Once the tumor has been removed and the replacement tissue has been removed, Dr. Massey performs the reconstruction surgery, using a microscope to attach the transplanted tissue to blood vessels in the neck so blood is going directly into reconstructed area. Sometimes called a “free flap” technique, this is the same microvascular reconstruction technique used in some breast cancer reconstruction surgeries.
This new technique is cosmetically and functionally superior to previous procedures. Froedtert & the Medical College of Wisconsin are proud to be one of the only facilities in the state offering this simultaneous procedure.
Reconstruction after Head and Neck Skin Cancers
In some cases, skin cancers of the head and neck require reconstruction to replace cancerous tissue that was removed. Aggressive melanomas and squamous cell carcinomas as well as other rare types of skin cancers most often require surgical removal paired with reconstruction.
Typically, surgical removal of the skin cancer and the reconstructive surgery are done during the same procedure. The head and neck surgeon and the plastic surgeon work together to achieve the best outcome for the patient.
In many cases, the surgeon removes the skin cancer and a margin of normal tissue around it. Once a pathologist in the operating room confirms that the margin of normal tissue is sufficient, the reconstruction can begin. The surgeon can use the healthy skin adjacent to the affected area to close the defect made when the skin cancer was removed.
Our highly skilled surgeons work to hide the incisions and use a variety of instruments, sutures and techniques to optimize the patient’s appearance. The principles of cosmetic surgery can be applied to reconstructive surgery, especially when treating head and neck skin cancers.
At Froedtert & the Medical College of Wisconsin, our collaborative team approach helps us tailor the many treatment options for each patient. Our goal is not just to remove the cancer and repair the defect but to restore function and preserve the patient’s appearance for the best possible outcome.
Head and neck surgeons, plastic surgeons, oncologist, radiation oncologists and other team members work together to ensure the removal of the skin cancer and the reconstruction are both successful. We understand the subtleties of how different approaches affect each other — for example, how radiation might affect reconstruction and vice versa. Specialists collaborate to develop an integrated, cohesive treatment plan that works for each patient.
Free Tissue Transfer
In cases where a larger area is affected or where adjacent tissue is not available or not healthy, a free tissue transfer might be used to reconstruct the defect. This technique involves taking tissue from one part of the body — the leg or arm, for example — and reattaching it to the blood supply in the area where the defect was created. This approach is less common for reconstructive surgery after head and neck skin cancers, but it’s an important option for patients who need it.