Building Head and Neck Cancer Care Around the Best Functional Outcomes for Patients

S+S, Fall 2023

Under the leadership of Dr. Zevallos, one of the big changes that is moving forward for the Department of Otolaryngology is to hire otolaryngology head and neck surgeons to perform complex head and neck reconstruction. Microvascular reconstructive surgery involves using tissues from other parts of the body and transplanting them to fix defects in the head and neck.  This can include using bone from the fibula bone to reconstruct the mandible after cancer surgery, and skin and muscle from the thigh or forearm to reconstruct the tongue, among many other applications.

The Department of Otolaryngology has recruited Matthew Spector, MD, one of the most experienced and accomplished head and neck microvascular surgeons in the United States, to lead this effort. As the Director of Head and Neck Surgical Oncology & Microvascular Reconstruction, the goal is to build a cutting-edge head and neck reconstructive surgery program at UPMC based in the Department of Otolaryngology. Kevin Contrera, MD, MPH, a head and neck surgical oncologist and microvascular reconstructive surgeon trained at MD Anderson Cancer Center, was also hired for the same reason.  These changes are in line with national trends at most major academic cancer centers across the United States, where highly trained head and neck microvascular reconstructive surgeons based in Otolaryngology perform the majority of these complex cases. 

“The major goal of the head and neck reconstructive program is to improve on the functional outcomes of patients who undergo reconstruction at UPMC,” Dr. Spector said. “Between Shaum [Sridharan], Kevin, and I, we have a wealth of skill and knowledge to perform these surgeries. We have trained across the country to bring in this expertise. When performing these complicated reconstructions, there are a number of goals. The overarching goal is to improve the speaking and swallowing outcomes of patients, to bring an individual back to their employment, and to maximize the cosmetic outcome, to name a few.”

The group will be able to not only provide these complex services, but also do further research on how to maximize these outcomes. They partner closely with Dr. Steve Kim, Dr. Zevallos, Dr. Jessica Maxwell, and Dr. Ferris, as well as the multidisciplinary team that includes speech-language pathology, medical oncology, and radiation oncology. They have interests in tongue reconstruction, soft tissue reconstruction after cutaneous cancer surgery, parotid reconstruction after salivary gland surgery, voice box reconstruction and throat reconstruction after larynx cancer surgery, reconstruction after trauma, and management of difficult head and neck wounds – among others.

“Our goal is to maximize function and minimize the morbidity of surgery using cutting-edge reconstructive techniques,” Dr. Spector explained. “We want to provide an individualized approach for each patient, understanding their goals and needs to provide the best outcome.”

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