Background: Cancers of the oral cavity present in a variable way but are often associated with persisting swelling or ulceration within the oral cavity. In the Indian subcontinent, oropharyngeal cancer is the common malignant tumour accounting for 40% of all cancers.
Aims and Objectives:To study the principles and outcomes of flaps used in reconstruction of carcinoma of cheek in view of maintaining oral competence, facilitate swallowing, preserving speech, prevent aspiration and to achieve better cosmesis.
Materials and Methods: A prospective, open label, randomized, hospital based, single centered study was conducted among 60 subjects attending Surgical Oncology OPD, K.R. Hospital attached to Mysore Medical College And Research Institute, Mysore meeting the inclusion and exclusion criteria over a period of 24 months from January 2016 to December 2017. All patients who present with symptoms and signs of Carcinoma cheek, and confirmed by Edge Biopsy, FNAC of Nodes, X-Ray mandible and ortho pantamogram were included in the study. Patients suffering from Ca lip, Ca tongue, Ca oropharynx and Ca maxilla are excluded. Descriptive statistics, Chi-square test, Multivariate Cox regression analysis were used to analyse the results. Results: The mean age group of the study subjects was 52.63+7.48 (34-86) years. The gender distribution showed 52(86.67%) females as compared to 8(13.33%) males. Maximum number of 29(48.33%) patients presents in Stage-IV while minimum number of 8(13.33%) patients presented in Stage-II. 13(21.67%) and 10(16.67%) patients presented in Stage-III and Stage-I respectively. 15(25%) and 17(28.33%) of patients underwent reconstruction with the Pectoralis major myocutaneous flap(PMMC) & PMMC+DP Flaps respectively. 6(10%) patients underwent tongue flap while 5(8.33%) patients underwent forehead flap (p <0.0001). 4(6.67%) and 1(1.67%) patients underwent Deltopectoral (DP) and tongue +DP flap respectively. Postoperative complications like infection and necrosis occurred in 3(5%) and 1(1.67%) cases respectively, while orocutaneous fistula occurred in 1(1.67%) cases and 1(1.67%) case showed recurrence. Conclusion: Patients subjected to reconstruction of cheek defect with PMMC & PMMC + DP flap shows better results in terms of oral competence, speech, swallowing & cosmetic appearance when compared to other flaps.