Craniofacial approach to tumors of the head and neck.

The type of surgery described in this article is safe and effective when performed by an experienced team of plastic surgeons and neurosurgeons. In a very extensive series of patients with tumors of the cranial base, there has been only one surgical death. It occurred the day after surgery and was thought to have resulted from an error in administering anesthesia. Reconstruction is limited in patients with malignant disease, especially when the tumor is recurrent after radiation therapy. It is better to delay and not hide any area of potential recurrence. Reconstruction can be performed at 12 to 18 months. In nonmalignant tumors, total reconstruction is performed. Extensive surgery can be carried out with a good chance of cure. Initial rehabilitation is with a prosthesis, but later reconstruction will give an acceptable result. Thus, both surgeon and patient may embark on this hazardous course with a much greater degree of security and equanimity.