Reconstruction in oral malignancy: Factors affecting morbidity of various procedures

Abstract

Aims and Objective:(1) To study the age and sex distribution of patient with oral malignancies. (2) To analyze various types of surgery performed. (3) Evaluation of reconstruction and factors affecting complications and its relation to the type of reconstruction.Materials and Methods:Cases of oral malignancies, undergoing surgery for the same in Sri Aurobindo Medical College and PG Institute, Indore from the period from October 1, 2012, to March 31, 2015.Results:Out of analysis of 111 cases of oral malignancy, 31 (27.9%) cases were in the fifth decade of life with male to female ratio 1.9:1. The commonest site of cancer was buccal mucosa. Forty-seven cases (43.2%) were in stage IVa. Diabetes was the most common co-morbidity reported, accounting for 53.9% of cases with reported morbidity. Tobacco chewing was the common entity in personal habits. All the cases underwent neck dissection along with resection of the primary. Hemimandibulectomy was the most preferred form of primary resection accounting for 53.15% (59 cases), followed by wide resection of primary 27% (30 cases). Pectoralis major myocutaneous (PMMC) flap only was the most common reconstruction across the study population. PMMC alone accounted for 38.7% (43 cases). The infection rate was 16.21%. PMMC alone accounted for 5 out of 18 (27.8%) of total infection rate, and 4.5% of the total study population. PMMC + deltopectoral accounted for 5 out of 18 (27.8%) of total infection rate, and 4.5% of the total study population.Conclusion:PMMC is a major workhorse for reconstruction with better functional outcome and acceptance among operated patients.

Oral Cavity Reconstruction over a 30-Year Period at a Dedicated Tertiary Head and Neck Cancer Centre

“…This is likely reflected in Table 4 with larger proportions of soft tissue free flaps used for more advanced tongue tumours. This is in comparison to centres in India, where the pectoralis major myocutaneous flap remains the workhorse, with one series identifying it used for 60% of all flaps for oral cancer reconstruction [29].…”

Submandibular gland flap in reconstruction of head and neck cancer defects

“…23 Studies have suggested that history of smoking, alcohol and diabetics may contribute to the early flap related complications; however, in this study, we encountered complication of partial flap necrosis in one case that too because of poorly controlled diabetes. 24,25 Mean harvesting time for raising the flap was less than 30 minutes since it was performed as a part of neck dissection compared to the supraclavicular artery island flap (45 minutes) in oral cavity carcinoma. 26 For oral cavity defect reconstruction we recommend passing the flap pedicle through the floor of the mouth to prevent tension and shearing of the pedicle.…”

Oncoreconstructive Microsurgeries as Current Treatment for Cancer Patient Nowadays in Indonesia’s Largest National Cancer Center: Freshly Graduated Microsurgeon Experience From 2019-2022

“…Patients who underwent microsurgeries were squamous cell carcinoma. Immediate reconstructive surgery is widely advised in the treatment of these patients as such treatment will increase the cure rate and reduce the morbidities and improve patient's quality of life (10,11).…”