ABSTRACT
Ablative surgery for malignancies of the upper aerodigestive tract is the most common
reason why the reconstructive surgeon is called upon to reconstruct adult head and
neck defects. An understanding of the pathophysiology and treatment of head and neck
malignancy is vital to the reconstructive surgeon so that restoration of both form
and function can be achieved. It is important to understand the behavior of cancers
of each head and neck subsite, as staging and ultimately the treatment of tumors from
each subsite is different. Historically, the standard treatment of head and neck cancer
was surgery and/or primary radiation therapy with surgical salvage for failure. Beginning
in the 1980s, advances in chemotherapy and concurrent delivery with radiation offered
new options to standard surgical therapy. Over the past two decades, the concept of
organ preservation using chemotherapy together with radiation therapy has been definitively
established. Yet, even with the strides made over these two decades with chemoradiation,
surgical treatment of head and neck cancer and reconstruction thereof will be an important
treatment option for the foreseeable future. Therefore, the relationship between the
extirpative and reconstructive surgeon is vital, and a clear understanding of the
biology and behavior of head and neck malignancy is crucial to successful patient
outcomes.
KEYWORDS
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David StepnickM.D. F.A.C.S.
Department of Plastic Surgery, University Hospitals Case Medical Center, 29001 Cedar
Road
Suite 202, Lyndhurst, OH 44124
eMail: David.Stepnick@uhhospitals.org