Complex Head and Neck Microvascular Surgery 2023

Modern surgical capabilities continue to develop and improve at an accelerating rate. Whereas less than 50 years ago a diagnosis of head and neck cancer or a devastating injury destined patients to lifelong disfigurement and severe functional deficits, in the recent decades, with the advent of microvascular free tissue transfer, the prognosis for these patients is no longer that grim. Even more fascinating, recent developments in the field of personalized surgery with computer-aided surgical planning and custom-made hardware allow us to perform devastating surgery with exceptional esthetic and functional outcomes due to outstanding reconstructive capabilities. We are fortunate to enjoy success rates well above 90% for microvascular tissue transfer. However, every single head and neck microvascular surgeon is keenly aware of the disastrous implications affecting patients’ life expectancy and quality of life if reconstruction failure occurs. The remarkably technically challenging surgery carried out successfully is just half the battle, however. Consideration of various perioperative aspects is essential to ensuring overall satisfactory patient outcomes. As the field of microvascular surgery is still relatively new, there are countless opportunities to continue to develop our understanding on how to improve patient care and surgical outcomes.