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8 1) Bakamjian VY: A two-stage method for pharyngo-esophageal reconstruction with a primary pecto ral skin flap. Plast Reconstr Surg (1965) 36, ) Ariyan S: The pectoralis major myocutaneous flap. Plast Reconstr Surg (1979) 64, ) Dos Santos LF: The vascular anatomy and dissection of the free scapular flap. Plast Reconstr Surg (1984) 73, 599.

9 6) Harii K: Microvascular tissue transfer. Lgakushoin (1983), New York. 7) Yang GC, Chen B and Gao Y: Forearm free skin flap transplantation; report of 56 cases. Natl Med J China (1981) 61, ) Taylor GI, Corlett RJ and Boyd JB: The extended deep inferior epigastric flap; A Clinical tech nique. Plast Reconstr Surg (1983) 72, ) Peter CR, McKee DM and Berry BE: Pharyngoesophageal reconstruction with revascularized jejunal transplants. Am J Surg (1971) 121, ) Harii K, Ebihara S, Ono I, Saito H, Terui S and Takano T: Pharyngoesophageal reconstruction using a fabricated forearm free flap. Plast Reconstr Surg (1985) 75, ) Wookey H: The surgical treatment of carcinoma of the pharynx and upper esophagus. Surg Gynecol & Obstet (1942) 75, ) Ariyan S: Further experiences with the pectoralis major myocutaneous flaps for the immediate repair of defects from excisions of head and neck cancers. Plast Reconstr Surg (1979)

10 The reconstructive surgery of head and neck cancers Shuichi WATANABE, Takashi KAWAKAMI, Ikuo INOKUCHI, Kin-ya UNO, Takuya OHOMICHI, Motoharu FUKAZAWA, Takaaki YONEDA, Kunihiro FUKUSHIMA, Yu MASUDA Department of Otolaryngology, Okayama University Medical School, Okayama 700, Japan (Director: Prof. Y. Masuda) Yasuaki KAMIKAWA First Department of Surgery, Okayama University Medical School, Okayama 700, Japan (Director: Prof. K. Orita) Thirty nine reconstructive surgeries were performed in 37 cases of head and neck cancers from January, 1989 to August, 1991 in our department. The best functional results were obtained on deglutition, swallowing and phonation after intraoral and/or mesopharyngeal reconstruction using free radial forearm flaps. The free jejunal transposition procedure had the lowest complication rate. The rectus abdominus musculocutaneous free flap was used for nasal, paranasal reconstruc tion. Esthetics could be presereved by this reconstruction method due to milder postoperative atrophy and contraction. Eye sockets for the artificial eyes were made with eye conjunctiva in 3 cases of extended total maxillectomy with the orbital exenteration. The use of microvas cular free flaps in this new plastic surgery resulted in the decrease of refusal of operations in maxillectomy cases.

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