Increased plate and osteosynthesis related complications associated with postoperative concurrent chemoradiotherapy in oral cancer

Sharan, Rajeev; Iyer, Subramania; Chatni, Shilpa; Samuel, Jacob; Sundaram, K. R.; Cohen, Richard F.; Pavithran, Keechilat; Kuriakose, Moni Abraham

doi:10.1002/hed.20886

Cited by 20 publications

(7 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although minor complications are common after salvage surgery (36%), major complications are uncommon (11%) and can be managed without significant sequelae. Chemoradiotherapy has been shown to adversely effect mandibular healing compared with radiotherapy alone 13. However, our institution has shown that the use of free flaps may improve healing following salvage surgery by introducing well‐vascularized, nonirradiated tissue 7.…”

Section: Discussionmentioning

confidence: 97%

Outcomes of salvage surgery with free flap reconstruction for recurrent oral and oropharyngeal cancer

et al. 2009

View full text Add to dashboard Cite

Objectives/Hypothesis-To evaluate outcomes of salvage surgery with free flap reconstruction for recurrent squamous cell carcinoma of the oropharynx and oral cavity with increased use of chemoradiotherapy.Study Design-Retrospective patient review.Methods-All patients undergoing salvage surgery with free flap reconstruction for oropharynx (n = 36) and oral cavity (n = 36) squamous cell carcinomas between January 2001 and January 2008 were obtained. Mean follow-up was 14 months. Previous chemoradiotherapy was used in 40% and radiotherapy alone in 60%.Results-Complications were more frequent in oropharynx than oral cavity tumors (36% and 14%, respectively; P = .05) requiring more secondary procedures (15 for oropharynx vs. six for oral cavity). Few patients returned to a normal diet (8%), and a majority retained an enterogastric feeding tube (56%). Median survival overall following salvage surgery was 44.8 months for oral cavity and 53.8 months for oropharynx head and neck squamous cell carcinoma. Overall estimated 1-, 2-, and 5-year observed survivals were 98%, 77.2%, and 43.7%, respectively. Twelve patients had a disease-free interval of <6 months, 92% of whom died of disease. Of 17 patients with disease at the primary site and involved regional lymph nodes, 94% died of disease.Conclusions-Salvage surgery with free flap reconstruction for recurrent oral and oropharyngeal tumors after chemoradiotherapy has acceptable morbidity and similar cure rates as salvage following radiotherapy without chemotherapy. Concurrent nodal recurrence and short disease-free interval are associated with reduced cure rates. A significant proportion will require enterogastric feeding and few will tolerate a normal diet.

show abstract

Section: Discussionmentioning

confidence: 97%

Outcomes of salvage surgery with free flap reconstruction for recurrent oral and oropharyngeal cancer

et al. 2009

View full text Add to dashboard Cite

show abstract

“…15 Exposure of the reconstruction plates is commonly associated with bone necrosis and radiation therapy. 16 In our series, three patients developed plate exposure. This can be prevented by preserving the viability of the underlying bone and providing vascular tissue cover as described above.…”

Section: Discussionmentioning

confidence: 61%

Morbidity Profile and Functional Outcome of Modified Facial Translocation Approaches for Skull Base Tumors

Kekatpure¹,

Rajan²,

Patel³

et al. 2011

Skull Base

Self Cite

View full text Add to dashboard Cite

The primary objective of this study was to evaluate morbidity associated with facial translocation approaches for skull base and results of various technical modifications. Forty consecutive patients who underwent facial translocation approaches for accessing skull base tumors from July 2005 to June 2010 were included in this study. There were 25 patients who underwent standard facial translocation, 4 patients medial mini, and 11 patients underwent extended facial translocation. Thirteen patients had benign disease and 27 patients had malignant disease. Resection was R0 in 36 and R1 in 4 patients. Most patients had acceptable cosmetic results. None of the patients had problems related to occlusion or speech and swallowing. The commonest complication observed was nasal crusting in 16 patients. Grade 2 trismus and exposure of mini plate was seen in three patients. Two patients developed necrosis of translocated bone. Three patients developed palatal fistula before modification of palatal incision. Facial translocation provides a satisfactory access for adequate clearance of skull base tumors with satisfactory aesthetic and functional results. With modifications of the surgical technique and implementation of new surgical tools, the morbidity of facial translocation approaches will continue to decrease.KEYWORDS: Facial translocation approach, morbidity, skull base, infratemporal fossa Tumors located within the nasopharynx, posterior maxilla, infratemporal fossa, and central skull base pose a significant challenge with regard to access and exposure. Successful treatment of these tumors depends upon adequacy of exposure and complete resection of the lesion. Several approaches such as the facial translocation, 1 the maxillary swing, 2 the infratemporal fossa, 3 the transpalatal 4 as well as the transmandibular 5 and endoscopic approaches 6 have been described to provide exposure for resection of these tumors. Most of these approaches are traditionally associated with significant functional and cosmetic consequences.

show abstract

“…6 Furthermore, patients who have undergone tumor resection via a mandibulotomy approach might be at a higher risk of adjuvant radiation-induced side effects of severe trismus and delayed bone healing. [7][8][9] TORS is well established as a safe and effective form of treatment for base of tongue tumors. It allows a clearer and wider view of the surgical field and better 3D visualization of structures, enabling more comfortable access to the tumor.…”

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Surgery Avoids Mandibulotomy in a Case of Adenoid Cystic Carcinoma of Base of the Tongue

Vidhyadharan

Thankappan

Subramaniam

et al. 2019

Craniomaxillofacial Trauma & Reconstruction

Self Cite

View full text Add to dashboard Cite

Surgical management is increasingly preferred in human papilloma–related oropharyngeal squamous cell carcinoma. Robotic surgery has a different role to play in oropharyngeal salivary origin tumors, where surgery is the primary essential modality. This modality may be used for better access to the oropharynx, avoiding a lip split approach with mandibulotomy. The organ preservation approach such as in oropharyngeal squamous cell carcinoma, with nonsurgical modalities like chemoradiotherapy, is not preferred in such cancers, as in the present case. In this context, robot-assisted surgery helps in reducing the morbidity by avoiding the mandibulotomy.

show abstract

Increased plate and osteosynthesis related complications associated with postoperative concurrent chemoradiotherapy in oral cancer

Abstract: Postoperative concurrent chemoradiotherapy significantly increases plate and osteosynthesis related complications in oral cancer.

Cited by 20 publications

References 31 publications

Outcomes of salvage surgery with free flap reconstruction for recurrent oral and oropharyngeal cancer

Outcomes of salvage surgery with free flap reconstruction for recurrent oral and oropharyngeal cancer

Morbidity Profile and Functional Outcome of Modified Facial Translocation Approaches for Skull Base Tumors

Robot-Assisted Surgery Avoids Mandibulotomy in a Case of Adenoid Cystic Carcinoma of Base of the Tongue

Contact Info

Product

Resources

About