Reconstructive and restorative techniques to replace postoperative defects of the oral cavity and cheek in patients with locally advanced squamous cell carcinoma
Kravets O.V., Kolesnik O.O., Cherniienko V.V., Khlynin O.V.
Summary. Objective. To compare the functional outcome and quality of life of patients with locally advanced squamous cell carcinoma of the oral cavity using various reconstructive and restorative techniques to replace postoperative defects of the oral cavity and cheek. Materials and Methods. There was conducted a comparative analysis of the results of surgical interventions performed in 150 patients with locally advanced squamous cell carcinoma of the floor of the mouth and buccal mucosa. The analysis revealed the following types of postoperative defect after primary tumor removal: superficial defect of the oral cavity was present in 29 patients, deep defect of the oral cavity was found in 65 patients, while medium and large defects of the buccal mucosa were present in 56 cases. Results. In the case of plastic replacement of superficial defects of the oral cavity, there was found a significantly (p=0.006) higher functional result in terms of the fortified diet in the group of patients who received the platysma myocutaneous flap compared with the group of patients who received the nasolabial flap (75.7±13.4% and 60.8±9.0%, respectively), and in the terms of human nutrition (p=0.04) in the group of patients with platysma myocutaneous flap compared with the group of nasolabial flap (80.4±14.5% and 68.8±11.3%, respectively). In the case of plastic replacement of deep defects of the oral cavity, a significantly (p<0.001) higher functional result was found in terms of the fortified diet in the group of patients who received the pectoralis major myocutaneous flap compared with the group of patients who receive the supraclavicular artery island flap (56.9±9.3% and 44±8.2%, respectively), and in the terms of human nutrition (p=0.005) in the group of patients with pectoralis major myocutaneous flap compared with the group of supraclavicular artery island flap (72.4±12.2% and 62±12.7%, respectively). In the case of plastic replacement of defects of the buccal mucosa, a significantly (p=0.007) higher functional result was found in terms of the fortified diet in the group of patients who received the skin flaps compared with the group of patients who received the fascial flaps (71.9±14,4% and 61.7±15%, respectively). Conclusions. There were determined the most effective reconstructive and restorative techniques for plastic replacement of the postoperative superficial and deep defects of the oral cavity and cheek.
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