Free radial forearm flap and anterolateral thigh flap for reconstruction of hemiglossectomy defects: A comparison of quality of life

Zhang, Peipei; Li, Meng; Shen, Jun; Liu, Hao; Zhang, Jun; Xiang, Xian-Ling; Yan, Ying-Bin

doi:10.1016/j.jcms.2018.10.006

Cited by 35 publications

(36 citation statements)

References 18 publications

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“…This type of infection is the leading cause of prolongation of hospital stay, higher medical expenses, and delayed chemoradiotherapy after head and neck surgery (McDevitt, Cancela Mde, Kelly, Comber, & Sharp, ; Penel et al, ). Surgery for oral cancer is defined as a clean‐contaminated surgery by the Centers for Disease Control and Prevention (CDC; Mangram, Horan, Pearson, Silver, & Jarvis, ), and reconstruction with a well‐vascularized free flap is standard treatment for a large defect after extended resection of oral cancer (Makiguchi, Yokoo, & Kurihara, ; Markiewicz et al, ; Zhang et al, ). However, the frequency of SSI in oral cancer surgery is high compared with other clean‐contaminated surgeries, especially in extended surgery with free flap reconstruction (Makiguchi, Yokoo, Kanno, Kurihara, & Suzuki, ; Ogihara, Takeuchi, & Majima, ).…”

Section: Introductionmentioning

confidence: 99%

Impact of skeletal muscle mass volume on surgical site infection in free flap reconstruction for oral cancer

et al. 2019

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Background: Sarcopenia is a disease in which skeletal muscle mass (SMM) and function are progressively lost. Here, we investigate surgical site infection (SSI) as a function of SMM in patients who underwent free flap reconstruction for a defect caused by oral cancer resection.Methods: A nonrandomized, retrospective group of 122 patients treated with free flap reconstruction after oral cancer resection was enrolled in the study. All subjects also underwent preoperative abdominal-lumbar computed tomography (CT). Crosssectional areas (cm 2 ) of skeletal muscles in the L3 region were measured by manual outline on CT images. The obtained areas were normalized for height (cm 2 /m 2 ), and the resulting value is referred to as the skeletal muscle index (SMI).Results: Recipient site SSI occurred in 30 patients (24.6%). Underweight status (body mass index [BMI] < 18.5 kg/m 2 ), anemia and lower SMI were significantly related to recipient site SSI in univariate analysis (p < . 05). In multiple logistic regression analysis, lower SMI was an independent significant risk factor for recipient site SSI (p = .015, adjusted odds ratio = 1.41 per 5 cm 2 /m 2 decrease).Conclusions: These findings suggest that a decrease in SMM might have more impact than a decrease in BMI on SSI in free flap reconstruction after resection of oral cancer.

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Section: Introductionmentioning

confidence: 99%

Impact of skeletal muscle mass volume on surgical site infection in free flap reconstruction for oral cancer

et al. 2019

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“…6 As such, descriptions of reconstructions are varied. 24,27,28 However, the optimal flap design is debatable. 6 The thinned anterolateral thigh free flap as well as supraclavicular and submental flaps have been proposed as alternatives.…”

Section: Discussionmentioning

confidence: 99%

“…13,25,26 Most reconstructive surgeons would agree that the radial forearm free flap best achieves these goals. 24,27,28 However, the optimal flap design is debatable.…”

Section: Discussionmentioning

confidence: 99%

Tongue reconstruction: Rebuilding mobile three‐dimensional structures from immobile two‐dimensional substrates, a fresh cadaver study

et al. 2019

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Objective To determine the two‐dimensional (2D) characteristics of flaps necessary to create three‐dimensional (3D) tongue anatomy. Methods Dissection of 11 fresh, nonpreserved human cadavers was performed. Six defects in each were created: total tongue, total oral tongue, hemiglossectomy, oral hemiglossectomy, total base of tongue, and hemi‐base of tongue. The resections were debulked to create flat, 2D mucosal flaps. The dimensions and shapes of these flaps were determined. Results Each specimen showed consistent dimensions and geometry between cadavers. The total tongue was pear‐shaped, the total oral tongue was egg‐shaped, the oral hemi‐tongue was bullet‐shaped, the hemi‐tongue resembled a dagger, the total base of tongue was rectangular, and the hemi‐base of tongue was hour‐glass shaped. Conclusion Typical dimensions and shapes of common tongue defects were determined. It is conceivable that customizing reconstructive flaps based on these data will increase the accuracy of neo‐tongue reconstruction, and thus, improve functional outcomes.

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“…The comparison of different surgical protocols implies taking into account some baseline confounding. For example, the pull-through resection involves various deep structures of the mouth floor that can more likely be restored by using free flaps [66], as clearly recognized by the authors. The cancer stage, adjuvant therapies, and the extent of resection also represent possible baseline confounding variables, since the cancer extent might force the surgeon to choose more invasive surgical approaches.…”

Section: Surgical Approachmentioning

confidence: 94%

Health-Related Quality of Life in Oral Cancer Patients: Scoping Review and Critical Appraisal of Investigated Determinants

Cicco

Tartaro

Fasano

et al. 2021

Cancers

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Background: health-related quality of life (HRQOL) represents a secondary endpoint of medical interventions in oncological patients. Our aim was to highlight potential sources of bias that could be encountered when evaluating HRQOL in oral cancer patients. Methods: this review followed PRISMA-ScR recommendations. Participants: patients treated for oral cancer. Concept: HRQOL assessed by EORTC QLQ-C30 and QLQ-H&N35/QLQ-H&N43. A critical appraisal of included studies was performed to evaluate the accuracy of data stratification with respect to HRQOL determinants. Results: overall, 30 studies met the inclusion criteria, totaling 1833 patients. In total, 8 sociodemographic (SDG) and 15 disease/treatment-specific (DT) HRQOL determinants (independent variables) were identified. The mean number of the independent variables was 6.1 (SD, 4.3)—5.0 (SD, 4.0) DT-related and 1.1 (SD, 1.8) SDG-related variables per article. None of the included papers considered all the identified determinants simultaneously. Conclusions: a substantial lack of evidence regarding HRQOL determinants was demonstrated. This strongly weakens the reliability of the reported findings due to the challenging presence of baseline confounding, selection, and omitted variable biases. The proposed approach recommends the use of further evaluation tools that gather more variables in a single score together with a selection of more homogeneous, reproducible, and comparable cohorts based on the identified baseline confounding.

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Free radial forearm flap and anterolateral thigh flap for reconstruction of hemiglossectomy defects: A comparison of quality of life

Cited by 35 publications

References 18 publications

Impact of skeletal muscle mass volume on surgical site infection in free flap reconstruction for oral cancer

Impact of skeletal muscle mass volume on surgical site infection in free flap reconstruction for oral cancer

Tongue reconstruction: Rebuilding mobile three‐dimensional structures from immobile two‐dimensional substrates, a fresh cadaver study

Health-Related Quality of Life in Oral Cancer Patients: Scoping Review and Critical Appraisal of Investigated Determinants

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