Closure of defects after resection of tumors of the oral cavity and the pharynx: medium- to long-term oncologic and functional results with the myocutaneous platysma flap

Abstract

The aim of this study was to assess the medium- to long-term functional and oncologic results when the myocutaneous platysma flap (MPF) was used for defect reconstruction of the oral cavity and the pharynx in selected patients. The MPF was used in 70 patients for closure of small to medium-sized defects. 37.1 % of the tumors were in the oral cavity, 24.3 % in the oropharynx and 38.6 % in the hypopharynx. Histopathological risk factors, adjuvant therapy, recurrence rates, and survival rates were assessed. Rehabilitation of swallowing and airways function was analyzed. UICC staging was I in 18.6 %, II in 15.7 %, III in 18.6 %, and IV in 47.1 %. Histopathological risk factors were noted in 51.4 and 84.3 % patients received adjuvant treatment. Recurrences were observed in 27.2 %. The 5-year recurrence-free survival rate was 63.1 %, and the disease-specific survival rate was 66.7 %. Permanent tracheostomy closure was achieved in 74.4 %, and complete recovery of swallowing in 57.4 %. Analysis of the functional and oncologic data after defect closure with the MPF showed acceptable results. The MPF should be included in the range of surgical methods for closure of small to medium-sized defects in the head and neck region in selected patients.

Epidemiology and survival of HPV‐related tonsillar carcinoma

“…The development of laser microsurgery and transoral robotic surgery improves the efficacy of surgical treatment . Many studies have confirmed that, with primary surgical treatment, excellent oncologic results with acceptable functional results can be achieved . A recent study showed that 266 patients with T1‐2N0‐1 OPC treated with surgery ± adjuvant therapy had DSS of 88.7% .…”

Platysma myocutaneous flap revised in the free flaps era: clinical experience in 61 patients

“…Reconstruction of oral cavity defects following radical surgery for SCC can be achieved by a variety of techniques [1][2][3][4][5][6] . The choice is influenced by several factors, including size and location of the defect, patient characteristics, donor site morbidity, and functional and aesthetic outcomes [1][2][3][4][5][6][7][8][9][10][11][12][13] . Nowadays microvascular free flaps, for instance anterolateral tight (ALTFF) and radial forearm (RFFF), are considered the gold standard among head and neck surgeons for restoration of oral defects.…”

“…Many loco-regional pedicle flaps are available for head and neck reconstruction [9][10][11][12][13][14][15] ; among these, the MPF presents some advantages, for instance appropriate thickness, ideal pliability, wide arch of rotation (almost 180°), and good colour match with facial skin in case of external reconstruction. Furthermore, donor site morbidity is low, and it is easy to access in the same operative field, reducing the operation time [1][2][3][4][5] . Consequently, MPF can be an excellent choice in reconstruction of oral cavity, oropharynx, and low face defects of small to medium size (15-75 cm 2 ) [1][2][3][4][5][6][7][8] ; however, some anatomical and oncological controversies on the use of this flap are still debated.…”

“…Furthermore, donor site morbidity is low, and it is easy to access in the same operative field, reducing the operation time [1][2][3][4][5] . Consequently, MPF can be an excellent choice in reconstruction of oral cavity, oropharynx, and low face defects of small to medium size (15-75 cm 2 ) [1][2][3][4][5][6][7][8] ; however, some anatomical and oncological controversies on the use of this flap are still debated. In particular, several authors have stated that it is difficult to perform a safe oncological neck dissection and at the same time preserve effective vascularisation of the flap [7][8][9][10][11][12] .…”

Experience in eliminating combined orofacial defects in the treatment of malignant neoplasms of the head and neck

“…Для устранения мягкотканных дефектов полости рта на протяжении многих десятилетий хирурги использова-ли различные аутотрансплантаты: местно-перемещенные [4], дельтопекторальные лоскуты [5,6], перемещенные осевые из большой грудной мышцы [7][8][9], из широчай-шей мышцы спины [10], свободные кожно-фасциальные аутотрансплантаты, такие как лучевой, переднебоковой лоскут бедра, локтевой поверхности предплечья, широ-кая фасция бедра, с боковой поверхности плеча, боковой поверхности бедра, заднелатеральной поверхности бедра [11,12]; висцеральные аутотрансплантаты, такие как тон-кокишечные [13,14], желудочно-сальниковые [15][16][17], толстокишечно-сальниковые [18,19].…”