Options for unwanted intraoral hair removal associated with flap reconstruction may include trimming, electrolysis, mechanical epilation, and laser and light epilation. These methods provide temporary relief and often require repeated treatment, with laser and light epilation providing the most durable response. Therapeutic external beam radiation used in the treatment of cancer is known to cause temporary alopecia at low doses and permanent alopecia at higher doses. We report a case of a man who underwent oncologic resection for early stage retromolar trigone cancer. His surgical defect required reconstruction with a submental flap. Post-operatively, his flap grew a thick beard within his oral cavity that was extremely bothersome. Due to the location of the flap, trimming, electrolysis, laser, and light epilation were not recommended treatment options. He was referred to us for consideration of external beam radiation with the goal of permanent alopecia of his intraoral graft.Keywords Palatal hair . Radiation-induced alopecia . Hair removal . Oral cavity reconstruction
Case reportA 71-year-old smoker presented with a pedicled mass on the left hard palate extending behind the maxillary gingiva, down the retromolar trigone to the posterior mandibular buccal sulcus, and onto the buccal surface. Biopsy confirmed a spindled squamous cell carcinoma. CT scan showed a 2.5×2.0 cm mass of the left posterior roof of the oral cavity. PET/CT scan confirmed uptake in the hard palate and left retromolar trigone with two hypermetabolic lymph nodes in level II. His past medical history included lung cancer treated with resection and adjuvant radiation 7 years prior, chronic obstructive pulmonary disease with oxygen dependence at night, and recurrent pneumonias. He had a 100+ pack-year smoking history and quit at the time of his diagnosis.Oncologic resection was performed, with pathology revealing two separate primaries. The first lesion was a 3.8-cm spindle cell squamous carcinoma of the hard palate with a depth of invasion of 2 mm, no bone involvement, no perineural invasion, and negative margins. The diameter of the pedicle of the mass was smaller than maximum diameter. The second lesion was a 1.5 cm moderately differentiated squamous cell carcinoma of the retromolar trigone with a depth of invasion of 2 mm, no bone invasion, and negative margins. Due to the proximity of the presenting lesions, they were resected in a single en bloc specimen. The ipsilateral neck was dissected and pathologically negative (0/14 lymph nodes). The resulting