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

  • G. LakshminarayanaEmail author
  • Shruti Venkitachalam
  • C. S. Mani
Original Article
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Abstract

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.

Keywords

Oral cancer defects Reconstruction Pedicled myocutaneous flaps Rationale Swallowing outcome 

Notes

Compliance with Ethical Standards

Conflict of interest

We have no conflicts of interest.

Ethics Statement/Confirmation of Patients’ Permission

As the study was retrospective, we neither required ethics approval nor patients’ permission.

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Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2019

Authors and Affiliations

  • G. Lakshminarayana
    • 1
    Email author
  • Shruti Venkitachalam
    • 1
  • C. S. Mani
    • 1
  1. 1.Cancer Research and Relief Trust, C/o Kumaran HospitalChennaiIndia

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