Oropharyngeal cancers are treated in multidisciplinary fashion with options including radiation, systemic therapy, and surgical resection. Depending on the stage, patients may be managed with definitive radiation or upfront surgical resection including neck dissection; but other than the lowest staged tumors without adverse pathologic features, almost all patients require radiation with or without chemotherapy [1]. This presents a dilemma for both resecting and reconstructing surgeons to offer the greatest chance of cure without creating unacceptable morbidity [2].