Department of Otolaryngology - Head and Neck Surgery

  1. Baylor College of Medicine
  2. Departments
  3. Otolaryngology - Head and Neck Surgery
  4. Research
  5. Head and Neck Reconstruction

Head and Neck Reconstruction

Master
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Virtual surgical plan for a total maxillary reconstruction using an osteocutaneous fibula free flap. Three figures show a lanned resection of the maxilla and hard palate, a planned fibula shaping osteotomies to create the neo-maxilla and palate and a planned completed fibula reconstruction of the maxillectomy and palatectomy deformity.
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Virtual surgical plan for a total maxillary reconstruction using an osteocutaneous fibula free flap. Figure A: Planned resection of the maxilla and hard palate. Figure B: Planned fibula shaping osteotomies to create the neo-maxilla and palate. Figure C: Planned completed fibula reconstruction of the maxillectomy and palatectomy deformity.
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Quality Outcomes and Measures for Microvascular Free Tissue Transfer of the Head and Neck

The treatment of head, neck, and skin cancers often involves extensive surgeries that can lead to significant disabilities, including impaired swallowing, cosmetic deformities, and loss of voice. Use of complex reconstructive modalities such as microvascular free tissue transfer has afforded surgeons the ability to restore a patient’s form and function (jawbone, skin, throat), improving quality of life and therapeutic potential. Our reconstructive team is a high-volume microvascular free tissue transfer center and has worked extensively locally and nationally to analyze functional outcomes, devise novel surgical techniques, and establish metrics to measure quality following these intensive procedures.

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Recent Publications:

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Virtual surgical plan of segmental mandibulectomy performance and fibula free flap reconstruction with same-day placement of osseointegrated dental implants. Panorex dental X-rays and 3-D reconstructed CT scan imaging of the pre-operative diseased mandible and post-operative reconstruction with dental implants and teeth in place.
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Virtual surgical plan of segmental mandibulectomy performance and fibula free flap reconstruction with same-day placement of osseointegrated dental implants. Panorex dental X-rays and 3-D reconstructed CT scan imaging of the pre-operative diseased mandible and post-operative reconstruction with dental implants and teeth in place.
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Wang R, Horwich P, Sandulache VC, Hernandez DJ, Hornig J, Graboyes EM, Liou NE, Skoner J, Haskins AD, Ranasinghe V, Day TA, Sturgis EM, Huang AT. Safety of microvascular free tissue transfer reconstruction of the head and neck in the setting of chronic pharmacologic immunosuppression. Head Neck. 2022 Jul;44(7):1520-1527. 

Shum J, Manon V, Huang A. A combined transoral and contralateral submandibular approach in the surgical management of osteoradionecrosis of the mandible with free flap reconstruction. J Oral Maxillofac Surg. 2022 Sep;80(9):1544-1549.

Macias D, Hand BN, Pipkorn P, Williams AM, Chang SS, Zenga J, Nilsen ML, Rhoten BA, Huang AT, Osazuwa-Peters N, Maurer S, Balliet W, Li H, Ruggiero KJ, Sterba KR, Graboyes EM. Association of Inventory to Measure and Assess imaGe Disturbance – Head and Neck Scores with Clinically Meaningful Body Image-Related Distress Among Head and Neck Cancer Survivors. Front Psychol. 2021 Dec 10;12:794038. doi:10.3389/fpsyg.2021.794038. eCollection 2021.

Macias D, Hand BN, Maurer S, Balliet W, Ellis MA, Pipkorn P, Huang AT, Nilsen ML, Ruggiero KJ, Williams AM, Marsh CH, Li H, Rhoten BA, Sterba KR, Graboyes EM. Factors Associated with Risk of Body Image-Related Distress in Patients with Head and Neck Cancer. JAMA Otolaryngology Head Neck Surg. 2021 Dec 1;147(12):1019-1026.

Shi J, Ayeni T, Gallagher KK, Patel AJ, Jalali A, Hernandez DJ, Haskins AD, Sandulache VC, Sturgis EM, Huang AT. Reconstructive outcomes of multilayered closure of large skull base dural defects following open anterior craniofacial resection. Journal of Neurological Surgery Part B: Skull Base. 2021 Feb 22;83(4):359-366.

Mays AC, Yarlagadda B, Achim V, Jackson R, Pipkorn P, Huang AT, Rajasekaran K, Sridharan S, Rosko AJ, Orosco RK, Coughlin AM, Wax MK, Shnayder Y, Spanos WC, Farwell DG, McDaniel LS, Hanasono MM. Examining the relationship of immunotherapy and wound complications following flap reconstruction in patients with head and neck cancer. Head Neck. 2021 May;43(5):1509-1520.

Sheehan CC, Haskins AD, Huang AT, Hernandez DJ. Cephalometric and functional mandibular reconstructive outcomes using a horizontal scapular tip free flap. Otolaryngology Head Neck Surg. 2021 Sep;165(3):414-418.

Harris BN, Ghazizadeh S, Bayon R, Kejner AE, Cannady SB, Greene BJ, Huang AT, Curry J, Blackwell KE, Ducic Y, Wax MK.  Safety of fibula free flap in patients following total knee replacement. Head Neck. 2021 Feb;43(2):585-589.

Hudson CS, Huang AT. Perforator-based propeller flaps for reconstruction of massive anterolateral thigh donor site wounds. Head Neck. 2020 Dec;42(12):E49-E52.

Chen DW, Ellis MA, Horwich P, Sandulache VC, Liou NE, Hernandez DJ, Sturgis EM, Graboyes EM, Hornig JD, Day TA, Huang AT. Free flap inset techniques in salvage laryngopharyngectomy repair: impact on fistula formation and function. Laryngoscope. 2021 Mar;131(3):E875-E881.

Graboyes EM, Hand BN, Ellis MA, Huang AT, Nilsen ML, Pipkorn P, Marsh CH, Maurer S, Day TA, Sterba KR. Validation of a novel, multi-domain head and neck cancer- and function-distress patient-reported outcome measure. Otolaryngology Head Neck Surgery. 2020 Nov;163(5):979-985.

Fancy T, Huang AT, Kass JI, Lamarre ED, Tassone P, Mantravadi AV, Alwani MM, Subbarayan RS, Bur AM, Worley ML, Graboyes EM, McMullen CP, Azoulay O, Wax MK, Cave TB, Al-Khudari S, Abello EH, Higgins KM, Ryan JT, Orzell SC, Goldman RA, Vimawala S, Fernandes RP, Abdelmalik M, Rajasekaran K, L’Esperance HE, Kallogjeri D, Rich JT. Complications, mortality, and functional decline in patients 80 years and older undergoing major head and neck ablation and reconstruction – a multi-institutional cohort study. JAMA Otolaryngology – Head & Neck Surgery. 2019 Oct 10;145(12):1150-7.

Kansara S, Wang T, Koochakzadeh S, Liou NE, Graboyes EM, Skoner JM, Hornig JD, Sandulache VC, Day TA, Huang AT. Prognostic factors associated with achieving total oral diet following osteocutaneous microvascular free tissue transfer reconstruction of the oral cavity. Oral Oncology. 2019 Nov;98:1-7.

Chen DW, Wang T, Shey-Sen Ni J, Sandulache VC, Graboyes EM, Worley M, Hornig JD, Skoner JM, Day TA, Huang AT. Prognostic factors associated with achieving total oral diet after glossectomy with microvascular free tissue transfer reconstruction. Oral Oncology. 2019;92:59-66.