Compartmental tongue resection with submental island flap reconstruction for large carcinoma of the oral tongue

Roshdy, Sameh; Elbadrawy, Mohamed; Khater, Ashraf; Elzahaby, Islam A.; Fady, Tamer; El-Hadaad, Hend Ahmed; Shams, Nazem; El-Barbary, Hany Mohamed

doi:10.1007/s10006-017-0627-0

Cited by 7 publications

(3 citation statements)

References 18 publications

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“…Its use has also proven to decrease operative times, hospital stay, and ultimately morbidity and cost. 3,[5][6][7] However, its oncological safety remains controversial, with regards to the nodal basins in the vicinity of the pedicle, namely levels IA and IB, and despite meticulous dissection, the possibility of transferring occult lymph node metastases to the recipient site is still a concern. 8,9 In an attempt to overcome these concerns in our earlier series, we modified our harvest technique by first completing an oncologically sound neck dissection and limited the use of the flap to node negative patients and excluded patients that were previously irradiated.…”

Section: Discussionmentioning

confidence: 99%

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The contralateral based submental island flap for reconstruction of tongue and floor of mouth defects: Reliability and oncological outcome

et al. 2020

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Background Submental artery island flap (SIF) is a viable alternative to free flaps for selected oral‐cavity defects, however, concerns about its oncologic safety still exists. A novel harvesting technique and its outcome is described in here. Methods This is a prospective study for patients with lateralized oral tongue and/or floor of mouth (FOM) cancers who undergone reconstruction using pedicled SIF based on contralateral submental vessels (CSIF) following resection. Results Forty‐one patients were included. Twenty‐four patients had T2, 13 had T3, and 4 had T1 tumors. The largest flap skin paddle was 15 × 9 cm. One patient sustained complete and five sustained partial flap loss. Three patients developed tongue tethering. Median follow‐up was 13.6 months. Locoregional recurrence occurred in 11 patients (26.8%); 6 oral‐cavity recurrences (14.6%), 6 ipsilateral, and 1 contralateral neck recurrences (2.4%). Conclusion CSIF is a reliable flap that addresses the oncologic controversy and overcomes the disadvantages of ipsilateral flap.

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Section: Discussionmentioning

confidence: 99%

“…This is especially favorable in older patients who have more redundant skin available for harvest and whose general condition may not be suitable for more complex procedures. Its use has also proven to decrease operative times, hospital stay, and ultimately morbidity and cost 3,5‐7 …”

Section: Discussionmentioning

confidence: 99%

The contralateral based submental island flap for reconstruction of tongue and floor of mouth defects: Reliability and oncological outcome

et al. 2020

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“…In the conventional surgery group, the universally accepted standard treatment was performed with a wide resection of the primary tumor with larger free macroscopic margins (1.5–2 cm)[ 14 ]. In the AUSR group, the entire anatomical unit (or subunit) with tumor involvement was completely removed.…”

Section: Methodsmentioning

confidence: 99%

Application of anatomy unit resection surgery for lateral basicranial surgical approach in oral squamous carcinoma

Liu

Gong

et al. 2023

BMC Oral Health

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Background The basicranial region lacks definite boundaries and includes various anatomical units. We developed a novel concept of the posterior oral anatomical complex (POAC) to identify these anatomical units in the basicranial region. OSCC with POAC involvement is termed posterior oral squamous cell carcinoma (POSCC) with poor prognosis. The principal aim of this study was to evaluate the effect of anatomy unit resection surgery (AUSR) on patients with POSCC. Methods A total of 120 POSCC patients who underwent radical surgical treatment were recruited for this study. These POSCC patients were treated with conventional surgery or AUSR. According to the extent of primary tumor resection in the AUSR group, the lateral basicranial surgical approach can be subdivided into four types: face-lateral approach I, face-lateral approach II, face-median approach or face-median and face-lateral combined approach. Facial nerve function was evaluated according to the House-Brackmann Facial Nerve Grading System. Results The overall survival rate was 62.5% and 37.5% in the AURS group and conventional group (hazard ratio: 0.59; p < 0.0001), respectively. The disease-free survival rate was 62.5% and 34.3% in the AURS group and conventional group (hazard ratio: 0.43; p = 0.0008), respectively. The local disease control rate in the AURS group (71.4%) was significantly better than that in the conventional group (34.4%) in present study (p < 0.0001). Compared to the conventional group, all the patients undergoing AURS were classified as T4 stage and presented with more lymph node metastasis (71.4%). A total of 20 patients (face-lateral approach I and face-lateral combined approach) were temporarily disconnected from the temporofacial branch of the facial nerve. Fifteen patients exhibited slight paresis, and five patients presented with moderate or severe paresis. The survival rate of zygomatic arch disconnection was 94.6% (54 of 56 patients). Conclusion This lateral basicranial surgical approach based on AUSR improves the survival rate and enhances the local control rate while also preserving a good prognosis without damaging the nerve and zygomatic bone. This surgical approach based on AUSR provides a novel and effective surgical treatment to address POSCC with better prognosis, especially for patients without metastatic lymph nodes.

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Refinements of the submental island flap donor site: a literature review and comparison among surgical specialties

et al. 2021

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Compartmental tongue resection with submental island flap reconstruction for large carcinoma of the oral tongue

Cited by 7 publications

References 18 publications

The contralateral based submental island flap for reconstruction of tongue and floor of mouth defects: Reliability and oncological outcome

The contralateral based submental island flap for reconstruction of tongue and floor of mouth defects: Reliability and oncological outcome

Application of anatomy unit resection surgery for lateral basicranial surgical approach in oral squamous carcinoma

Refinements of the submental island flap donor site: a literature review and comparison among surgical specialties

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