Surgical reconstruction after chemotherapy or radiation. Problems and solutions.

This article summarizes the most common effects of organ-preservation protocols on head and neck tissues. These highly successful regimens create special problems, such as wound complications and mandibular ORN, that the surgeon must consider. The evolution of reconstructive techniques for the head and neck, culminating with micro-vascular free-tissue transfer, has provided solutions to many of the problems created by these innovative treatments. Continued refinement of these techniques will offer patients the benefits of organ-sparing protocols while assuring an excellent functional outcome should salvage surgery become necessary.