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Pharynx, Cervical Esophagus, and Oral Cavity Reconstruction

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Principles of Cancer Reconstructive Surgery

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Abstract

Defects of the oral cavity, pharynx, and cervical esophagus pose a particular challenge in reconstructive surgery for patients with cancer because of their unique tissue elements, structure, integrated function, bacterial contamination, and proximity to other vital structures. The oropharynx and cervical esophagus are composed of specialized voluntary and involuntary muscles and fibrous connective tissue. The epithelial surfaces are thin, pliable mucosa coated with a film of saliva that supplies moisture, provides lubrication, initiates digestion, and controls bacterial flora. These tissues form elegant, compact, anatomically complex structures that have no exact autologous analogs to use for replacement. They are functionally integrated to coordinate speech, mastication, swallowing, and breathing. Impairment of one function necessarily affects each of the others to some degree. Complicating matters is the high level of bacterial colonization normally present in the oral cavity. Ordinarily, these bacteria are non-virulent but become so with surgery and/or radiotherapy-associated changes in the microenvironment. Finally, the carotid artery, internal jugular vein, and portions of cranial nerves V, VII, IX, X, XI, and XII are located immediately adjacent to the pharynx and cervical esophagus. These must be preserved and protected if they have not been removed with the tumor resection.

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Author information

Authors and Affiliations

  1. Division of Plastic Surgery, The Ohio State University, Columbus, OH, 43210, USA

    Michael J. Miller MD

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  1. Michael J. Miller MD
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Editors and Affiliations

  1. Department of Plastic Surgery, Division of Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, TX, 77230, USA

    Charles E. Butler MD, FACS

  2. Division of Plastic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA

    Neil A. Fine MD, FACS

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Miller, M.J. (2008). Pharynx, Cervical Esophagus, and Oral Cavity Reconstruction. In: Butler, C.E., Fine, N.A. (eds) Principles of Cancer Reconstructive Surgery. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-49504-0_9

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  • DOI: https://doi.org/10.1007/978-0-387-49504-0_9

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-387-49502-6

  • Online ISBN: 978-0-387-49504-0

  • eBook Packages: MedicineMedicine (R0)

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