There are types of Reconstructions in head and neck cancers. Also the timing of reconstruction is necessary keeping in mind the therapy that soon follows such reconstructions. what one needs to know? Reconstruction may be primary (performed at the time of resection of the tumor) or secondary (performed as a separate procedure after resection, or to repair a defect left by an ulcerative tumor treated by primary radiation). Primary reconstruction has become the standard of care for most patients.
Radiation causes a decrease in the vascular supply to the affected tissues, which can lead to reduced oxygenation and nutrient supply and impaired wound healing. The tissue response to radiation is bimodal with an acute and a chronic phase. The acute phase occurs during radiation and lasts a few weeks postradiation; the chronic phase causes long-term damage to the tissue.
Alloplasts are implants made of foreign material and include pins, trays, bars, and plates. The ideal material is made of an inert biocompatible material that can withstand force. Options include vitallium, stainless steel, and titanium. The alloplasts are readily available, allow for immediate reconstruction, do not affect later radiation or delayed reconstruction, and obviate the problem of donor site morbidity.
Complications include extrusion, fracture of the material, and plate exposure. Alloplasts play an important role for patients unable to tolerate long procedures or for those with lateral mandibular defects, but are not recommended for otherwise healthy patients
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