Choice of Regional Flaps for Oral Cancer Defects: Relevance in Current Era.

Autor: Lakshminarayana G; Cancer Research and Relief Trust, C/o Kumaran Hospital, No. 214, EVR Periyar Salai, Kilpauk, Chennai, Tamil Nadu 600010 India., Venkitachalam S; Cancer Research and Relief Trust, C/o Kumaran Hospital, No. 214, EVR Periyar Salai, Kilpauk, Chennai, Tamil Nadu 600010 India., Mani CS; Cancer Research and Relief Trust, C/o Kumaran Hospital, No. 214, EVR Periyar Salai, Kilpauk, Chennai, Tamil Nadu 600010 India.
Jazyk: angličtina
Zdroj: Journal of maxillofacial and oral surgery [J Maxillofac Oral Surg] 2021 Jun; Vol. 20 (2), pp. 246-251. Date of Electronic Publication: 2019 Nov 22.
DOI: 10.1007/s12663-019-01305-x
Abstrakt: Introduction: Microvascular free flaps (MVFF) are the current standard of care for reconstruction of oral ablative defects; however, pedicled myocutaneous flaps (PMCF) are still used widely in India. The rationale behind the preference for selecting PMCF in the present era is not well understood. The associated complications and swallowing outcomes are variable.
Methods: We retrospectively analysed the records of patients who underwent reconstructive surgery for oral cancer ablative defects over a 3-year period.
Results: Ninety-seven pedicled myocutaneous flaps [89 pectoralis major myocutaneous (PMMC) flaps, eight lower trapezius island myocutaneous (TMC) flaps] and 113 MVFFs were performed. The reasons for selecting PMCF were financial constraints 38.7%, MVFF salvage 22.5%, medically compromised 10.7%, vessel-depleted neck 6.4%, old age with PS2 + 5.3%, early recurrence 5.3%, borderline resectable 4.3%, palliative resection 2.1%. Overall complication rate was 20.4%. Of patients, 50.7% and 34.7% were on regular and semisolid diet, respectively; 66.6% had acceptable swallowing-related social well-being.
Conclusion: PMCFs have an important role in developing countries with patients having financial constraints. The other potential reasons driven by patient factors were discussed. The swallowing outcomes are good, with majority of the people having socially acceptable swallowing function.
Competing Interests: Conflict of interestWe have no conflicts of interest.
(© The Association of Oral and Maxillofacial Surgeons of India 2019.)
Databáze: MEDLINE
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