Predictors of Complications After Flap Reconstruction of Oral Cavity Defects Following Ablation of Squamous Cell Carcinoma

Rayan, Yasser Mohammed Seddeik Abd El Raheim; Khairallah, Sherif Mohamed; Mousa, Ahmed K; Alsharkawy, Kamal Abdel Aal Mohamed Hassanein; Kabbash, Mansour M

doi:10.21608/ejhm.2020.67902

Predictors of Complications After Flap Reconstruction of Oral Cavity Defects Following Ablation of Squamous Cell Carcinoma

Document Type : Original Article

Authors

¹ Department of Maxillofacial Surgery, Faculty of Medicine, Aswan University

² Department of Oncosurgery, National Cancer Institute, Cairo University

³ Department of Plastic Surgery, Faculty of Medicine, Aswan University

⁴ Department of Maxillofacial, Head and Neck Surgery, Faculty of Medicine, Sohag University

⁵ Department of General Surgery, Faculty of Medicine, Aswan University

10.21608/ejhm.2020.67902

Abstract

Background: Head and neck cancers represent the sixth most common cancer worldwide with an incidence of over 600,000 new cases per year. More than 90% of head and neck cancers are squamous cell carcinomas (SCC) that arise from the mucosal surfaces of the oral cavity, oropharynx and larynx. Objective: The aim of the current work was to investigate the predictors of complications after flap reconstruction of oral cavity defects following ablation of squamous cell carcinoma. Patients and methods: This prospective comparative study included a total of 41 patients who diagnosed to have oral SCCs, attending at the outpatient clinic of Head and Neck Surgery Unit, National Cancer Institute (NCI), Cairo University and Aswan University Hospital. Written informed consent of all the subjects was obtained after explaining the benefits and hazards for each method step. This study was conducted between 2015 to 2018. Approval of the ethical committee was obtained. Results: Patients with positive history of neoadjuvant chemoradiotherapy (CRTH) are 52% less likely to developing complications than those with negative history of neoadjuvant CRTH. Detection of the short-term oncologic outcome; in the 4 flaps was better in contralateral submental island flap (CSMIF) cases than others. CSMIF were found to be 58% less liable for recurrence in comparison with pectoralis major myocutaneous flap (PMMCF) that was why it didn't show any clinical or radiologically detectable recurrence within the period of 24 months postoperatively. Thoracodorsal artery perforator (TDAP) flaps were 2.6 times more liable for recurrence in comparison with PMMCF. RFFF flaps were found to be 1.2 times more liable for recurrence in comparison with PMMCF. Conclusion: The chosen 4 flaps for this study are applicable to be used for post ablative oral cavity reconstruction. Our flaps were equal in suitability for defect coverage (50-60%).

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