Free-flap reconstruction of large head and neck defects in the elderly

Advanced-stage and recurrent malignancies of the head and neck place severe demands on both the surgical team and the patient. Marked alterations in cosmesis and function are to be expected following major ablative surgery. The use of free tissue transfer with microvascular anastomoses has provided the head and neck surgeon the freedom to resect these lesions aggressively and to provide the patient with improved cosmesis, function, and protection of vital structures. A series of six cases involving patients at The University of Alabama at Birmingham over the past year is presented.