Intraoral reconstruction in head and neck cancer surgery

Numerous techniques are available to resurface the oral cavity. These range from the very simple and straightforward to the very difficult and complex. Certainly for small lesions, local excision and direct approximation of mucosa is all that is necessary. For larger defects, particularly those which will require some other form of reconstruction, additional tissue must be brought into the operative defect. For superficial excisions, skin or mucosal grafts are adequate to resurface the mouth. For areas of extensive resection, flaps of some type are required. The use of local random flaps, regional arterialized flaps, and myocutaneous flaps have been described. The decision for their use must be as individual as each patient. Free flap transfer has specific theoretical benefits. The advantages and disadvantages of each technique have been presented and, it is hoped, will allow the reconstructive surgeon greater latitude in selecting a technique of reconstruction.