Microsurgical reconstruction of head and neck: a historical review

Introduction: The advent of microsurgery has become a critical development in the reconstruction of structures in the head and neck (H&N) region, which may be damaged for various reasons. With the practice of anastomoses integrated into microsurgery, new perspectives in reconstructing a wide range of lesions have emerged, greatly enhancing patient functionality and well-being through its high efficiency and excellent applicability. Objective: To review and chronologically organize historical data on the evolution of microsurgical reconstruction of the head and neck. Methods: Between January and April 2023, information was extracted from the PubMed/MEDLINE database by two independent researchers, adhering to the study’s inclusion and exclusion criteria. Inclusion criteria encompassed peer-reviewed articles and relevant books published up to 2022 in Portuguese or English, primarily focused on the theme. Exclusion criteria included expert opinions, letters to the editor, and comments. Results: Significant innovations in microsurgery were observed predominantly during the 1970s and 1980s and this period marked the introduction of various new techniques and flaps, enhancing the effectiveness and appropriateness of reconstruction methods. Conclusion: Emerging in the 20th century, reconstructive microsurgery has since undergone significant advancements, particularly during the 1980s, with the development of various methods, technologies, and enhanced techniques. These advancements have led to numerous new techniques and improvements in older procedures.