A worldwide comparison of the management of T1 and T2 anterior floor of the mouth and tongue squamous cell carcinoma – Extent of surgical resection and reconstructive measures

Kansy, Katinka; Mueller, Andreas; Mücke, Thomas; Koersgen, Friederike; Wolff, Klaus; Zeilhofer, Hans‐Florian; Hölzle, Frank; Pradel, Winnie; Schneider, Matthias; Kolk, Andreas; Smeets, Ralf; Acero, Julio; Haers, P.; Ghali, G.E.; Hoffmann, Jürgen

doi:10.1016/j.jcms.2017.09.012

Cited by 19 publications

(8 citation statements)

References 28 publications

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“…It may be difficult to reliably obtain clear margins in cT2 tumors of the floor of mouth (FOM), gingiva, buccal mucosa, retromolar region, and palate without requiring free flap reconstruction of the defect, but this is at the discretion and experience of the surgeon. Conversely, the oral tongue can tolerate aggressive resection without significant detriment to function when repaired locally, meaning larger tumors can be suitable for SNB.…”

Section: Recommendationsmentioning

confidence: 99%

Surgical consensus guidelines on sentinel node biopsy (SNB) in patients with oral cancer

et al. 2019

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Background The eighth international symposium for sentinel node biopsy (SNB) in head and neck cancer was held in 2018. This consensus conference aimed to deliver current multidisciplinary guidelines. This document focuses on the surgical aspects of SNB for oral cancer. Method Invited expert faculty selected topics requiring guidelines. Topics were reviewed and evidence evaluated where available. Data were presented at the consensus meeting, with live debate from panels comprising expert, nonexpert, and patient representatives followed by voting to assess the level of support for proposed recommendations. Evidence review, debate, and voting results were all considered in constructing these guidelines. Results/Conclusion A range of topics were considered, from patient selection to surgical technique and follow‐up schedule. Consensus was not achieved in all areas, highlighting potential issues that would benefit from prospective studies. Nevertheless these guidelines represent an up‐to‐date pragmatic recommendation based on current evidence and expert opinion.

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Section: Recommendationsmentioning

confidence: 99%

Surgical consensus guidelines on sentinel node biopsy (SNB) in patients with oral cancer

et al. 2019

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“…Microsurgical reconstruction is preferred for large tongue defects providing adequate bulk to improve swallowing function, preventing cicatricial restriction of tongue mobility and preserving the “finger function” of the tongue (Chepeha, ). The radial forearm (RF) and the anterolateral (ALT) free flaps are among the most popular reconstructive options worldwide (Kansy et al, ).…”

Section: Introductionmentioning

confidence: 99%

The thin profunda femoral artery perforator flap for tongue reconstruction

et al. 2019

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Background With the ongoing global epidemic of obesity in the Western countries, thigh flaps such as the profunda artery perforator (PAP) free flap, have been less favorable for glossectomy reconstruction due to large bulk of adipose tissue associated with traditional subfascial harvest. In this article, we present a series of 10 patients who underwent reconstruction with suprafascial PAP free flaps following oncologic tongue resection. Methods Our series included six men and four women with an average age of 53.9 years old (range, 28–71 years). All patients underwent preoperative computed tomographic angiography (CTA) for selection of the most suitable perforator and preoperative design of its customized thickness. Flap elevation was performed at the superficial fascia layer while modifying the plane of dissection according to the specific bulk needs in each case. Results Flaps survived in nine patients; one flap failed due to vasospasm. Mean pedicle length was 7.4 cm (range, 6–8 cm). Skin paddle dimensions varied between 8 × 6 and 15 × 9 cm. Flaps thicknesses ranged from 0.4 to 3 cm. Functional outcome was evaluated at 6 months follow up: good speech and deglutition functional outcomes relative to extent of resection were observed. Conclusions The dissection above the superficial fascia layer represents an important refinement to the traditional fasciocutaneous PAP flap. Flap thickness can be tailored to avoid excess of bulk in the medial thigh observed in larger BMI populations.

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“…A further reason may be that we removed a full section of bone along with the periosteum, a critical source of bone‐forming osteoblasts and MSCs (Lin, Fateh, Salem, & Intini, 2014). This resembles how the resection procedure has to be carried out in many clinical cases such as when infected or tumor‐hosting bone is removed with safety margins (Kansy et al, 2017). The removal of the periosteum creates a difficult environment for bone formation because all bone‐forming cells would have to migrate to the defect from adjacent bone and bone marrow.…”

Section: Discussionmentioning

confidence: 99%

Treating mouse skull defects with 3D‐printed fatty acid and tricalcium phosphate implants

Jensen

Slots

Ditzel

et al. 2020

J Tissue Eng Regen Med

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Skull surgery, also known as craniectomy, is done to treat trauma or brain diseases and may require the use of an implant to reestablish skull integrity. This study investigates the performance of 3D printed bone implants in a mouse model of craniectomy with the aim of making biodegradable porous implants that can ultimately be fitted to a patient's anatomy. A nonpolymeric thermoplastic bioink composed of fatty acids and β‐tricalcium phosphate was used to 3D print the skull implants. Some of these were sintered to yield pure β‐tricalcium phosphate implants. The performance of nonsintered and sintered implants was then compared in two semi‐quantitative murine calvarial defect models using computed tomography, histology, and luciferase activity. Both types of implants were biocompatible, but only sintered implants promoted defect healing, with osseointegration to adjacent bone and the formation of new bone and bone marrow tissue in the implant pores. Luciferase scanning and histology showed that mesenchymal stem cells seeded onto the implants engraft and proliferate on the implants after implantation and contribute to forming bone. The experiments indicate that fatty acid‐based 3D printing enables the creation of biocompatible and bone‐forming β‐tricalcium phosphate implants.

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A worldwide comparison of the management of T1 and T2 anterior floor of the mouth and tongue squamous cell carcinoma – Extent of surgical resection and reconstructive measures

Cited by 19 publications

References 28 publications

Surgical consensus guidelines on sentinel node biopsy (SNB) in patients with oral cancer

Surgical consensus guidelines on sentinel node biopsy (SNB) in patients with oral cancer

The thin profunda femoral artery perforator flap for tongue reconstruction

Treating mouse skull defects with 3D‐printed fatty acid and tricalcium phosphate implants

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