Download PDF
Semin Plast Surg 2025; 39(04): 259-264
DOI: 10.1055/s-0045-1814080
Review Article

Secondary Reconstruction in Head and Neck Cancer

Authors

  • Hanpon Klibngern

    1   Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

  • Hsiao-Jui Kuo

    2   Division of Plastic and Reconstructive Surgery, Jen-Ai Hospital, Dali Branch and Chang Gung University College of Medicine, Taichung, Taiwan

  • Runyu Zhu

    3   Department of Otolaryngology, Head and Neck Surgery, Sengkang General Hospital, Singapore

  • Chung-Kan Tsao

    4   Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan

  • Huang-Kai Kao

    4   Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
Further Information
Also available at
   Permissions and Reprints

Abstract

Secondary reconstruction in head and neck cancer refers to surgical procedures performed following the initial primary reconstruction to address complications, residual defects, or recurrent or second primary tumors. The timing of secondary reconstruction can be categorized as either immediate or delayed. Immediate reconstruction is typically required in cases of flap failure or acute complications such as fistula or great vessel exposure. In contrast, delayed reconstruction addresses long-term sequelae such as trismus, oral incompetence, and mandibular or maxillary defects, as well as late complications including plate exposure and osteoradionecrosis (ORN). The interval between initial treatment and secondary reconstruction may range from several months to several years, depending on the clinical condition and patient preference. Thorough planning and appropriate patient selection are critical for optimal functional and aesthetic outcomes. This article focuses on conditions commonly encountered in delayed secondary reconstruction; immediate reconstruction is covered elsewhere.

Keywords

head and neck - free flap - secondary reconstruction


Publication History

Article published online:
18 December 2025

© 2025. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA