Past, present and future directions and rational approach in reconstruction of head and neck cancer

The main problem of head and neck cancer is the consequence of a devastating tumor and the impaired functional and esthetics outcome due to its treatment, sometimes surgery, radiation, chemotherapy or a combination of them. It usually affects quality of life. Reconstruction when necessary is vital to allow the tissues a proper scarring while interposing healthy tissue also promoting start adjutancy earlier and also improving rehabilitation, function, esthetics and quality of life. For more than a century reconstruction has been developing trying to achieve such goal, starting from ingenious techniques to rotate or transplant a new and healthy tissue, up to the use of technology to improve the microvascular free flaps results. In the millennium of technologies, a rational approach must be considered to avoid falling in the sometimes unnecessary trend of insetting free flaps and instead offer the best and fair to guarantee a cure or control of cancer with the best quality of life, taking into special consideration the rational use of economical and scientific resources