Oral Cavity Reconstruction

Quadri, Pablo; McMullen, Caitlin

doi:10.1016/j.otc.2023.04.002

Cited by 5 publications

(6 citation statements)

References 85 publications

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“…The reconstruction of defects resulting from oral cavity oncologic surgery is often imperative, not only for aesthetic reasons but primarily for functional purposes. The primary goal of reconstruction is to ensure the separation of the oral cavity from other anatomical spaces, avoiding salivary fistula and infection 4 . Secondly, it aims to restore the function of the affected subsite, ensuring an acceptable quality of life.…”

Section: Discussionmentioning

confidence: 99%

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Systematic review of minimally-invasive reconstructive options for oral cavity defects

Calabrese,

Fazio,

Bassani

et al. 2024

Acta Otorhinolaryngol Ital

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SUMMARY The oral cavity is a primary site for malignant neoplasms of the head and neck region. Surgery, with or without adjuvant therapy, offers the highest probability of cure by focusing on radical tumour removal and organ function restoration. Reconstructive options are represented by local and free flaps, while small defects can be managed without reconstruction. For medium-sized defects without bone involvement, local flaps can be a good alternative to free flaps in selected patients. The purposes of this article are to analyse the main minimally-invasive reconstructive techniques in oral cancer surgery through a systematic review of the literature and develop a reconstructive algorithm based on the site and size of the defect. We defined minimally-invasive reconstruction as any reconstructive option not involving flap dissection from the neck or other distant areas from the oral cavity. Options considered include: local myo-mucosal or mucosal flaps (based on the facial or buccal arteries, and palatal flap), Bichat’s fat pad flap, and nasolabial flap. Use of biological or synthetic materials is also described. In selected patients with small to moderate-sized defects, the possibility of reconstruction with local flaps can be a viable option.

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Section: Discussionmentioning

confidence: 99%

“…Reconstructive options are represented by local, loco-regional, and free flaps. Small defects can be managed without reconstruction 4 . In these cases, the use of synthetic materials promote healing and aid postoperative pain control.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of minimally-invasive reconstructive options for oral cavity defects

Calabrese,

Fazio,

Bassani

et al. 2024

Acta Otorhinolaryngol Ital

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“…One of the most frequently used distant flaps is the radial forearm flap, which is used especially for soft tissue reconstruction (8,10). Due to its small thickness, easy flap elevation, and good perfusion, it is also ideal for covering palatal defects (10).…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of SCC in the oral cavity for operable patients usually consists of surgical tumor resection, unilateral or bilateral neck dissection, and one-or two-stage defect reconstruction in the respective anatomical localization (6,7). In addition to local flaps, multiple, particularly microsurgical, distant flaps have been developed in recent decades, which are mainly considered "state of the art therapy" (8,9). Some of the most common surgical distant flap techniques are the radial forearm flap and the osteomyocutaneous fibula flap (9).…”

mentioning

confidence: 99%

“…Some of the most common surgical distant flap techniques are the radial forearm flap and the osteomyocutaneous fibula flap (9). These can be used depending on the defect coverage (soft tissue, bone, mixture) and have various advantages and disadvantages as well as (contra-)indications (8,9). However, depending on previous operations and individual patient factors (e.g., recurrent SCC after operation and/or radiotherapy), microsurgical reconstruction is sometimes not suitable.…”

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confidence: 99%

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Temporalis Flap for Soft Palate Reconstruction – More than an Alternative for Patients Unsuitable for Microvascular Reconstructive Surgery

DUDDE,

BARBAREWICZ,

HENKEL

2024

In Vivo

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Background/Aim: The treatment of squamous cell carcinoma (SCC) in the oral cavity for operable patients usually consists of surgical tumor resection, unilateral or bilateral neck dissection and defect reconstruction. In addition to local flaps, multiple, particularly microsurgical, distant flaps have been developed, which are mainly considered state of the art reconstruction. However, depending on previous operations and individual patient factors, microsurgical reconstruction is sometimes not suitable. Case Report: A 54-year-old male presented to the Department of Oral and Maxillofacial Surgery with leukoplakia-like changes in the area of the soft palate. Radiological and histopathological findings revealed SCC of the soft palate. Due to the patient's reduced general condition, pronounced vasosclerosis and the patient's negative opinion towards microsurgical reconstruction, the indication for tumor resection with simultaneous temporalis flap reconstruction was made. The temporalis flap showed sufficient healing throughout the follow up. Conclusion: For patients who are unsuitable for microsurgery (previous operations, radiation, patient's request), well-known local flaps such as the temporalis flap represent more than an alternative treatment for defect reconstruction. The temporalis flap is particularly suitable for defect reconstruction of the maxilla and palate due to its easy flap raising and low complication rates. This case report shows the step-by-step flap raising of temporalis flap for soft palate reconstruction.

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Early feeding after free flap reconstruction of the oral cavity: A systematic review and meta‐analysis

Barlow,

Sragi,

Rodriguez

et al. 2024

Head & Neck

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BackgroundTraditionally, patients undergoing free flap reconstruction for oral cavity defects have been given nothing by mouth for 6–14 days post‐operatively due to concern for orocutaneous fistula development.MethodsMultiple databases were screened for studies assessing the rate of orocutaneous fistula formation in early (≤5 days) versus late (>5 days) feeding groups following oral cavity free flap reconstruction. Fixed‐ and random‐effects meta‐analyses were used.ResultsOne randomized controlled trial, one prospective cohort, and three retrospective cohort studies were included. The early feeding group displayed no significant increase in orocutaneous fistula formation (RD = −0.02, p = 0.06) or free flap failure (RD = −0.01, p = 0.39), with a significantly shorter hospital length of stay (mean difference [days] = −2.43, p < 0.01).ConclusionsWhile further prospective trials are necessary, initiation of oral intake before post‐operative day 5 may be appropriate in properly selected patients following oral reconstruction.

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Oral Cavity Reconstruction

Cited by 5 publications

References 85 publications

Systematic review of minimally-invasive reconstructive options for oral cavity defects

Systematic review of minimally-invasive reconstructive options for oral cavity defects

Temporalis Flap for Soft Palate Reconstruction – More than an Alternative for Patients Unsuitable for Microvascular Reconstructive Surgery

Early feeding after free flap reconstruction of the oral cavity: A systematic review and meta‐analysis

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