Novel microsurgery in Mexico allows head and neck reconstruction

The Mexican Social Security Institute (IMSS) announced that since 2016, specialists in plastic and reconstructive surgery of the High Specialty Medical Unit (UMAE) Specialty Hospital of the National Medical Center La Raza, use a microsurgical technique to reconstruct large defects in the area of the head and neck.

The case of Guillermo Martinez, 36 years old, public transportation driver, who performed a routine mechanical check, accidentally hit his nose and that generated a tumor in the jaw, which as it grew affected the nostril, part of the eye, and jaw.

Two years ago he had a complete resection of the tumor with the entire dental arch, since it was under the skin and all over the bone.

Afterward, the reconstruction of a microsurgical flap of bone, taken from the fibula, was required so that the defect of the face could be filled, a plaque could be placed, and then the patient decided to have dental implants.

"I knew it was complicated, but the doctors gave me the confidence and I put myself in their hands. Here at Social Security they did change my life completely because I was afraid to go out on the street and that people would see me; now that I came to this Hospital, my life changed, today I can go out into society, see myself as a normal person, my appearance changed", commented Guillermo Martínez.

With the use of state-of-the-art technology such as a surgical microscope and a suture almost invisible to the human eye, images through the portable Doppler system and infrared cameras to closely monitor the life of the flaps after implantation, it has been possible to benefit an approximate of 50 to 100 patients each year.

Dr. Alejandro Cruz Segura, the reconstructive plastic surgeon, said that microvascular skin, muscle, and bone flaps have become the first choice for treatment of large defects of the face and neck, and the microsurgical technique contributes to their successful survival of them.

This technique consists of performing an autotransplant from a distant site of the patient's body to another affected area, in which vessels, arteries, and nerves of approximately one millimeter in diameter are joined; with this, the flap continues to receive blood and does not die.

Defects of the head and neck represent challenging reconstructive problems, given their relationship to important anatomical structures involved in functions such as vision, speech, chewing, and swallowing.

Seeing the results in these patients generates great personal satisfaction but above all to see an improvement in their quality of life, they return to their daily activities, said Dr. Alejandro Cruz Segura.

In 2016, the Service of Plastic and Reconstructive Surgery of the Specialties Hospital of the National Medical Center La Raza, performed between 70 and 80 annual procedures with a survival rate and success rate of 95 percent.