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Comparison of the hospitalization period after microvascular reconstruction flap in trismus patients: free anterolateral thigh flap versus free forearm flap

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Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

The primary strategy for treating oral squamous cell carcinoma (OSCC) is therapeutic resection, with the trismus resection defect reconstructed via free flap. The most popular free flaps include the radial forearm free flap (RFFF) and anterolateral thigh free flap (ALT). This study investigated the relationships between the hospitalization period and a variety of surgical outcomes, as well as maximum inter-incisor distance (IID), in trismus patients who chewed betel nuts.

Materials and methods

Forty-nine primary OSCC patients who chewed betel nuts and underwent surgical resection and reconstruction between 2010 and 2016 were enrolled in this retrospective study. The data were from a single center in Taiwan. The outcome variable after flap recovery surgery was the duration of postoperative hospitalization. Other factors that were analyzed comprised correlations between hospitalization and a variety of factors, including postoperative inter-incisor distances (IIDs), operative time, gender, and WBC count, upon stratification into two reconstruction groups.

Results

The mean postoperative hospitalization duration in the ALT group was 22.9 ± 7.2 days, which was significantly shorter than that in the RFFF group (27.8 ± 7.0 days; p = 0.019). Two-week postoperative IID (ALT group: 16.1 ± 0.8 mm; RFFF group: 7.0 ± 0.6 mm) was inversely related to the duration of hospitalization (p = 0.022, r = − 0.372).

Conclusions

The ALT flap is more effective than the RFFF flap to reduce the length of hospitalization in trismus patients.

Clinical relevance

The ALT flap should be considered as a first-line technique in OSCC reconstruction in trismus patient reconstruction.

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Funding

This study was supported by research grants from Tri-Service General Hospital, Republic of China (Grant Nos. TSGH-C106-004-006-008-S05, TSGH-C107-008-S06, TSGH-C108-007-008-S06, TSGH-C106-144, TSGH-C105-164, TSGH-C108-189), Ministry of National Defense, Republic of China (Grant No. MAB-106-090), and National Science Council, Taiwan, Republic of China (Grant No. MOST 105-2314-B-016-021-MY3).

This research was also supported by the Cancer Registry Group and Medical Records Room of Tri-Service General Hospital.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Tri-Service General Hospital, 2F, No. 325, Sec. 2, Chenggong Rd., Neihu District, Taipei City, 114, Taiwan, Republic of China

    Wei-Chin Chang & Yuan-Wu Chen

  2. National Defense Medical Center, Taipei City, Taiwan, Republic of China

    Wei-Chin Chang, Cheng-Yu Yang & Yuan-Wu Chen

  3. Department of Internal Medicine, China Medical University Hospital, Taichung City, Taiwan, Republic of China

    Ching-Fen Chang

  4. Department of Dentistry, Tri-Service General Hospital, Taipei City, Taiwan, Republic of China

    Chia-Mao Cheng

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  1. Wei-Chin Chang
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Correspondence to Yuan-Wu Chen.

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The authors declare that they have no conflict of interest.

Ethical approval

The Ethical Committee of the Tri-Service General Hospital (Taipei, Taiwan) approved this retrospective study (institutional review board protocol no: 2-107-05-021).

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Informed consent was obtained from all individual participants included in the study.

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Chang, WC., Chang, CF., Cheng, CM. et al. Comparison of the hospitalization period after microvascular reconstruction flap in trismus patients: free anterolateral thigh flap versus free forearm flap. Clin Oral Invest 23, 2951–2957 (2019). https://doi.org/10.1007/s00784-018-02799-4

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  • DOI: https://doi.org/10.1007/s00784-018-02799-4

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