Oral Cancer

pp 1–10 | Cite as

Challenges in multi-unit reconstruction: a framework perspective

  • Brittany R. BarberEmail author
  • Brett A. Miles
Review Article



Locally advanced or recurrent head and neck cancer can present both oncologic and reconstructive challenges. There are no current guidelines for reconstruction of multi-unit defects, yet reconstructive goals should serve the purpose of providing a safe healing environment for both adjuvant therapy and functional rehabilitation. In light of a younger head and neck cancer population, reconstructive methods aimed at preserving form and function over a long survivorship period are optimal.


The review of the literature regarding use of single or double free flaps, with or without locoregional reconstructive options, and new techniques for multi-unit defects is described.


Managing complex defects with multiple units involves determining a framework of critical, optimal, and optional elements for each reconstruction with consideration of the medical tolerance of the patient and long-term functional rehabilitation.


Multi-unit reconstruction should involve distinction of critical, optimal, and optional aspects to provide a safe healing environment for both adjuvant therapy and functional rehabilitation fit for long-term survivorship.


Multi-unit reconstruction Free tissue transfer Head and neck Free flap 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Otolaryngology Head and Neck SurgeryUniversity of WashingtonSeattleUSA
  2. 2.Department of Otolaryngology Head and Neck SurgeryIcahn School of Medicine at Mount SinaiNew YorkUSA

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