Otolaryngology
Head & Neck Surgery

Stanford Microvascular Reconstruction

Treatment of head and neck cancer can alter patients’ quality of life by changing the way they look, speak, and eat.  At Stanford’s Head and Neck Cancer Program, our multidisciplinary team is comprised of cancer surgeons, reconstructive surgeons, and speech and swallowing rehabilitation therapists who all work in close collaboration.  During evaluation of patients for cancer surgery, reconstructive surgery is carefully considered and recommended when it can reduce the side effects of cancer treatment.

Reconstructive surgeries are chosen based on how to optimally restore a patient’s function and appearance.  In some cases, reconstruction of a head and neck defect can be accomplished by using tissue within the head and neck.  However, in situations where the defects get too large or require special components such as bone, reconstructive surgeons must look to tissue in different body sites.  In these instances, microvascular reconstruction is recommended.


What is Microvascular Reconstruction?

Microvascular reconstruction is a surgical procedure that involves moving a composite piece of tissue from another part of the body to the head and neck.  The tissue most commonly comes from the arms, legs, or back, and can include bone, skin, fat, and/or muscle.  The details of what is moved and where it is moved from are dependent on the reconstructive needs.  Transfer of the tissue to the head and neck allows us to do things such as rebuild a jaw, optimize tongue function, or reconstruct the throat.

When these pieces of tissue are moved, they require their own blood supply for survival in their new location.  This is similar to how a transplant works, except we are using a patient’s own body to provide the reconstructive tissue.  After the reconstruction is carefully secured in the head and neck, the blood vessels that feed the tissue transplant are reconnected to new blood vessels in the neck.   Since these blood vessels are usually 1 to 3 millimeters in diameter, the connections must be done with a microscope - hence, the term “microvascular surgery.”  

This type of reconstruction may also be combined with other advanced surgical techniques, such as computer modeling, 3D printing, and customized implant fabrication.  Prior to surgery, patients undergo careful assessment of functional impact and necessary rehabilitation planning.


Evalution for Microvascular Reconstruction

All patients referred to the cancer center for surgical resection of cancer are evaluated for microvascular reconstruction.   However, not every patient will require it, depending on the cancer surgery needed, the overall health of the patient, and a careful evaluation of potential functional and cosmetic changes from the cancer removal. 

For patients who have traumatic injuries or osteoradionecrosis (radiation damage to bone), microvascular surgery is occasionally necessary and referrals can also be placed through our cancer center coordinators to arrange an appointment.


Stanford OHNS Head & Neck Microvascular Surgeons:

Vasu Divi, MD
Davud Sirjani, MD


Appointments

Appointments for Microvascular Surgery evaluation can be made by contacting:

(650) 723 - 5400

 

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