The human face is a unique anatomical structure that personalizes the head and neck region. Not only does it give the owner individual identity and animated personality it is the dynamic focus for cognitive, emotional, visual, aero-digestive and speech function. Extreme facial cancer potentially ravages these critical physiological functions and facial deformity resulting from this is perhaps as confronting as the stigma of severe facial trauma. This chapter considers the unique anatomy of the face in terms of the different mechanisms by which facial cancers can spread ie by direct extension and by infiltration of the nerve and lymphovascular networks that supply the face. These networks of anatomical connection have direct implications for the brain and the neck, which are in close proximity to the human face. With a series of clinical cases, illustrated with selected CT and MRI scans, the anatomical spread of facial cancers is charted to demonstrate the common scenarios. The anatomical mechanisms of cancer spread have an important bearing on the resection plan and reconstructive solutions. We also consider the anatomical implications of adjuvant radiation therapy for patients with advanced facial cancer and introduce the principles of modern maxillofacial prosthetic rehabilitation in the twenty-first century.
- Cancer growth and patterns of spread
- Soft tissue and bone planes
- Loco-regional recurrence and anatomical implications