Head and Neck Microvascular Reconstruction in Puerto Rico: Developing a Two-team approach to Microvascular Reconstructive Surgery

Abstract

Hypopharyngeal carcinoma as a subsite of head and neck cancer, carries with it the lowest 5-year relative survival rate. Treatment of hypopharyngeal cancer relies on single therapy or multimodality treatment: surgery, radiation and/or chemotherapy. When surgical intervention is chosen, the type of operation depends on the extent of the lesion and the regions involved and will often require some form of reconstruction. We present the case of a 69-year-old male patient with T4aN3M0 hypopharyngeal carcinoma treated in Puerto Rico utilizing a two-team approach for removal of the primary tumor as well as harvesting of the free-flap for reconstruction. This approach allows for decreased operative time by having two surgical teams operating at the same time. The benefits of free flap reconstruction include: larger resection margins, better functional outcomes in terms of swallowing, and decreased post-operative morbidity in irradiated patients.