Outcomes research in head and neck reconstruction

Modern management of advanced upper aerodigestive tract malignancy often results in profound effects on function and appearance. These functions include speech, deglutition, mastication, taste, oral hygiene, and airway maintenance. The most commonly studied site in the head and neck is the oromandibular complex. The primary goals of reconstruction are the preservation and restoration of these functions along with socially acceptable cosmesis. Achieving these objectives is not to be accomplished at the expense of acceptable oncologic principles. With the availability of microvascular free tissue techniques, single-stage oromandibular reconstruction is now commonly performed. Few studies, however, have critically examined the functional outcomes of these techniques. To date, these investigations have been limited and retrospective. Lack of a uniform system for reporting defect size and locations as well as patient function and quality of life has limited the utility of the available data. In this article, outcomes research in head and neck reconstruction is discussed with regard to objective study parameters using the oral cavity as a model. Pertinent current literature is cited.