Abstract
BACKGROUND: Reconstruction of the pharynx after ablative cancer surgery is challenging. Restoration of function and esthetics is at the forefront. There is currently no gold standard for reconstruction. The workhorses for free flap reconstruction are the radial free forearm flap or the anterolateral thigh flap. For medium size defects the free lateral arm flap is an excellent alternative. OBJECTIVE: The current article discusses the advantages and disadvantages of the different free flap options from the perspective of two experiences head and neck surgeons and describes the usual steps in pharyngeal reconstruction. CONCLUSION: The ideal choice of reconstruction depends on the size and volume of the defect, the availability of donor vessels, and also on the experience and preference of the surgeon.