Resection and immediate reconstruction for patients with "inoperable" recurrent head and neck cancer.

An approach to the patient with a recurrent head and neck cancer following prior combined radiation, surgery, and possibly, chemotherapy has been outlined. Following a detailed evaluation of the patient's symptoms, the local extent of the recurrence, and the search for distant disease, resection of the recurrent tumor with immediate reconstruction of the resulting defect is advocated. Although reconstructive efforts may be taxing because of prior use of optimal tissue, imaginative planning and improvisation will allow functional and cosmetic restoration in many cases. Illustrative cases have been included to demonstrate the efficacy of this approach in treating patients with recurrent cancer of the head and neck.