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July 15, 1992

Otolaryngology—Head and Neck Surgery

Author Affiliations

University of Texas Medical Branch, Galveston

JAMA. 1992;268(3):395-397. doi:10.1001/jama.1992.03490030107047

Exciting advances during the past year in the specialty of otolaryngology—head and neck surgery have increased our understanding of several common diseases and disorders and improved our ability to treat patients with these problems. Reconstructive surgery, pediatric otolaryngology, and otology have benefited particularly from important new scientific information.

Restoring facial contour, speech, and swallowing and chewing functions to near-normal levels after segmental mandibular resection for cancer is a challenging goal. The movement of the jaw and tongue and the large forces applied during mastication combine with complex anatomic features and the need for sensory input to create demands that have not been met fully prior to the introduction of microvascular free-tissue transfer techniques. Recent clinical studies have demonstrated the greater viability and durability of composite-free grafts (bone, muscle, and skin) that are vascularized. The iliac crest, scapula, metatarsus, rib, and radius are the most common donor sites, with the selection