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

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...

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Bibliographic Details
Published in:Journal of maxillofacial and oral surgery 2021-06, Vol.20 (2), p.246-251
Main Authors: Lakshminarayana, G., Venkitachalam, Shruti, Mani, C. S.
Format: Article
Language:English
Subjects:
Cardiovascular disease
Comorbidity
Dentistry
Diabetes
Fistula
Infections
Medicine
Medicine & Public Health
Oral and Maxillofacial Surgery
Oral cancer
Original
Original Article
Otorhinolaryngology
Patients
Plastic Surgery
Radiation therapy
Surgery
Surgical outcomes
Swallowing
Tongue
Well being
Wound dehiscence
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Summary: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.
ISSN:0972-8279
0974-942X
DOI:10.1007/s12663-019-01305-x