Choice of Regional Flaps for Oral Cancer Defects: Relevance in Current Era
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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.
We retrospectively analysed the records of patients who underwent reconstructive surgery for oral cancer ablative defects over a 3-year period.
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.
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.
KeywordsOral cancer defects Reconstruction Pedicled myocutaneous flaps Rationale Swallowing outcome
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.