Reconstructive Options in Head-and-Neck Cancer Surgeries
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Date
2019-07
Journal Title
Journal ISSN
Volume Title
Publisher
International Research Organization for Life & Health Sciences (IROLHS)
Abstract
Introduction: Surgery is the standard treatment to achieve cancer control, but due to socioeconomic and other factors, most patientspresent with a locally advanced tumor leading to extensive resection of mucosa, muscle, bone, and skin. Reconstruction of thesedefects is essential not only in ensuring function and cosmesis but also in enabling the start and completion of adjuvant therapy on time.Aim: The study aims to analyze the various reconstruction methods used in the head-and-neck cancer surgery.Materials and Methods: Various cancers of the head and neck using various reconstruction options such as primary closure, localflaps, and regional flaps. Pre-operative radiotherapy, extent of defect, the type of reconstruction used, post-operative complications,and the functional outcome in the immediate post-operative period, 1 month after surgery, and at 6 months were recorded.Results: Of the 180 surgeries for head-and-neck cancers, primary closure was done in 79 cases. Other reconstruction optionsused were pedicled regional flaps – 75, local flaps – 11, and split skin grafting – 15. Of the 79 primary closures, 2 cases ofinfection, 2 cases of partial necrosis (neck skin and tongue), 8 cases of minor wound dehiscence, and 2 cases of fistulae of whichone was chylous were noted. Of the 50 pectoralis major myocutaneous (PMMC) flaps, 29 were for lining the oral/oropharyngealcavities, 6 were for cover the skin defects, and 15 were for both lining and cover.Conclusion: PMMC is the choice flap in high-volume centers with resource and time constraints where microsurgical expertiseis not available. They have proved effective in the absence of microvascular free flaps. Further improvement in our results canbe achieved if free flaps could be used in a choice few cases and effective mandibular reconstructions are to be used.
Description
Keywords
Head-and-neck cancer, Microvascular free flaps, Reconstruction
Citation
Shanmugasundaram Sundaram, Shunmugam Deepa, Gandhi Anitha. Reconstructive Options in Head-and-Neck Cancer Surgeries. International Journal of Scientific Study. 2019 Jul; 7(4): 70-74