Next generation of head and neck free flap reconstruction: the future of innovation and refinement.

IF 2 4区医学 Q2 OTORHINOLARYNGOLOGY

Current Opinion in Otolaryngology & Head and Neck Surgery Pub Date : 2025-10-01 Epub Date: 2025-08-01 DOI:10.1097/MOO.0000000000001077

Kelly L Staricha, Joshua D Smith, Richard A Raad, Shaum Sridharan, Kevin J Contrera, Steven B Chinn, Matthew E Spector

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引用次数: 0

Abstract

Purpose of review: We briefly review the history of surgical innovation in free flap reconstruction of the head and neck. With a specific focus on maximizing patient QoL by prioritizing a 'precision reconstruction', we then posit novel avenues for surgical refinement to usher in the next generation of head and neck free flap reconstruction.

Recent findings: Patients undergoing free flap reconstruction of the head and neck increasingly co-prioritize preservation of quality-of-life (QoL) alongside the desire to survive their diagnosis. In the contemporary era, this fact has prompted microvascular surgeons to customize reconstructive plans to minimize decisional regret and maximize favorable functional and cosmetic outcomes for their patients. Increasingly popular strategies for surgical refinement and innovation in this space include novel flap harvest techniques, unconventional flap donor sites, and use of flow-through configurations, all of which are routinely utilized in our group's practice. Additional strategies gaining traction in head and neck reconstruction include vascular perfusion imaging with indocyanine green fluorescence angiography and 'Jaw-in-a-Day' surgeries leveraging computer-aided design (CAD)/computer-aided manufacturing (CAM) technologies.

Summary: The next frontier of innovation in free flap reconstruction of the head and neck will prioritize custom, patient-specific reconstructions that consider the unique anatomic, functional, and aesthetic needs of each patient (i.e. precision reconstruction).

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下一代头颈部自由皮瓣重建：未来的创新和细化。

回顾目的：我们简要回顾了头颈部自由皮瓣重建的外科创新历史。通过优先考虑“精确重建”，我们特别关注最大限度地提高患者的生活质量，然后我们假设手术改进的新途径，以迎来下一代头颈部自由皮瓣重建。最近的研究发现：接受头颈部自由皮瓣重建的患者越来越优先考虑维持生活质量（QoL）和生存的愿望。在当代，这一事实促使微血管外科医生定制重建计划，以最大限度地减少决策后悔，并最大限度地提高患者的良好功能和美容效果。在这个领域，越来越流行的手术改进和创新策略包括新颖的皮瓣收获技术，非常规的皮瓣供体位置，以及流动配置的使用，所有这些都在我们小组的实践中经常使用。在头颈部重建中获得关注的其他策略包括血管灌注成像和利用计算机辅助设计(CAD)/计算机辅助制造（CAM）技术的“每日下颌”手术。摘要：头颈部自由皮瓣重建的下一个创新前沿将优先考虑定制，患者特异性重建，考虑每个患者独特的解剖，功能和美学需求（即精确重建）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Otolaryngology & Head and Neck Surgery OTORHINOLARYNGOLOGY-

CiteScore

2.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Otolaryngology & Head and Neck Surgery is a bimonthly publication offering a unique and wide ranging perspective on the key developments in the field. Each issue features hand-picked review articles from our team of expert editors. With eleven disciplines published across the year – including maxillofacial surgery, head and neck oncology and speech therapy and rehabilitation – every issue also contains annotated references detailing the merits of the most important papers.