Structured reconstructive planning for head and neck surgery
Sugan Shegar & Keval Shah
A rule-based decision-support tool ranking free flap, regional, and local reconstructive options against defect, patient, and donor-site parameters — with explicit reasoning behind every recommendation.
Select a site to begin. Fields update automatically based on your inputs.
Case basics
ℹ Hard palate — treated as Brown Class I (palatal only; infrastructure intact). For more extensive maxillary resection select Maxilla.
Consider 'No' for salvage cases, high-risk or frail patients, recipient vessel failure, or where prolonged anaesthesia is contraindicated.
Geometry
Enter tumour dimensions from CT or known defect size
Tumour dimensions (from CT / imaging)— dimensions will be used to estimate post-resection defect with surgical margin
Tick when tumour breaches full thickness of the cheek. T4a by AJCC 8th edition criteria regardless of measured dimensions.
Mandible — Planned bony resection
Drives continuity vs replacement pathway
Relevant when implant rehabilitation or occlusal plane restoration is planned.
Maxilla / Palate — Defect class
Brown classification — determines separation, support, and implant strategy
For palate-only defects select Hard/soft palate as site — Class II–IV apply to maxillectomy.
Auto-confirmed for Class III/IV. Tick manually for Class II if floor is resected.
Indicates composite defect with external skin loss — dual-surface reconstruction will be required.
Class III: contents may be preserved. Class IV: exenteration confirmed.
Modifiers & priorities
Select a site to infer priority
Clinical judgement required — both thin and bulk are viable for this defect.
