Combined submandibular gland flap and sternocleidomastoid musculocutaneous flap for postoperative reconstruction in older aged patients with oral cavity and oropharyngeal cancers

Abstract

BackgroundThe growth of aging populations in an increasing number of countries has led to a concomitant increase in the incidence of chronic diseases. Accordingly, the proportion of older aged patients with oral cavity and oropharyngeal cancers and comorbidities has also increased. Thus, improvements must be made in the tolerance and safety of surgical procedures for these patients with complex medical conditions. In this study, we investigated combined submandibular gland flap and sternocleidomastoid musculocutaneous flap for postoperative reconstruction in older aged patients with oral cavity and oropharyngeal cancers in terms of surgical methods, safety, and clinical outcome.MethodsBetween January 2011 and May 2012, 8 patients over the age of 65 years (7 men, 1 woman; aged 66 to 75 years (median, 69.6)) with oral cavity and oropharyngeal cancers underwent combined submandibular gland and sternocleidomastoid myocutaneous flaps for postoperative reconstruction at Ganzhou Tumor Hospital. All eight patients had comorbid cardiovascular, cerebrovascular, or chronic respiratory disease or diabetes. Clinical outcomes, complications, and tolerance to surgical treatment were observed.ResultsSurgical treatment was successful in all eight patients. All submandibular gland flaps survived with well-mucosalized surfaces and with no complications. During the postoperative follow-up period of 12 to 28 months, no patient developed local recurrence or distant metastasis, and all had good recovery of function and local contour.ConclusionsThis combined reconstruction technique enables appropriate restoration of oral function, facial aesthetics and improved quality of life. Further, this technique has several advantages: it is easier to perform, reduces operation time and surgical risk, causes less surgical injury, and has minor impact on contour. The technique provides a new and safe reconstruction option for older aged patients with oral cavity and oropharyngeal cancers.

The preservation and application of the submandibular gland in oral squamous cell carcinoma (STROBE)

“…The surgical method used was the same as described in formal literature. [9] 2.2.2.4. Postoperative observational indicators.…”

Closure of Orocutaneous Fistula Using Submandibular Gland as a Pedicled Flap

“…Yang et al [ 9 ] used the submandibular gland flap successfully for the reconstruction of the defects in the infratemporal region after tumor resection. In addition, Zhang et al reported the usage of submandibular gland flap for the reconstruction of oral cavity [ 10 ].…”

>Method to prevent cheek depression using an island sternocleidomastoid muscle flap with the middle pedicle as a feeding vessel in immediate reconstruction of the facial nerve with the sural nerve following resection of a parotid gland tumor

“…Many reports have described tissue defect reconstruction after the excision of head and neck tumors using a sternocleidomastoid muscle or myocutaneous flap as a nerve bed [1][2][3]. An advantage of this method is that it provides additional blood flow for the transplanted nerve.…”