Soft-tissue reconstruction of the oral cavity

In our early experience with head and neck reconstruction, we evaluated our results mainly by the final contour of the mandible. With further experience, the bony reconstruction has become more and more accurate, and it is the intraoral soft-tissue reconstruction that poses the continued challenge. Better preoperative and postoperative evaluation will improve our operative planning, and our results will continue to improve. We must be able to compare our cases with those of other centers by appropriately categorizing deficits into specific structures removed to allow relevant comparison of results. We should no longer accept the simple view of the oral cavity deficit as a uniform soft-tissue loss that requires nothing more than closure. Nor can we continue to accept the evaluation of postoperative results of head and neck reconstruction by a simple external photograph; rather, this must be combined with a true visual and functional assessment of the oral cavity. In this way, the combined effort of head and neck surgeons will help to advance the cause of oral cavity reconstruction as rapidly as has occurred with reconstruction of the mandible.