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Background. Oral mucosal cancer is the most prevalent squamous cell cancer of head and neck, with 6,723 cases registered in Russia, including 94 per Volgograd Region, in 2018. A high tumour advancement and complex topography of the surgical area result in extensive soft-tissue defects and impaired swallowing, chewing and speech.Aim. Efficacy assessment of submental myodermal flap application in buccal reconstruction after extended combined oncological resections.Materials and methods. Submental myodermal flap was used as a buccal reconstruction technique in 112 patients aged 42 to 75 years during 2015–2020. Surgery for primary tumour was performed in 88 cases, and in 24 — for recurrence after radiotherapy or surgical excision.Results and discussion. A six-year experience of the submental myodermal flap usage in reconstructive surgery allowed evidently wider indications for extensive oral resection combined with extended, also bilateral, lymphadenectomy. Clinical records on the technique application in primary and recurrent cancer are presented.Conclusion. The submental myodermal flap technique in combination with extended or extended combined surgery for oral mucosal cancer notably increases the tumour resectability at this location and improves function restore in patients. The method widens indications for higher-volume operative aid, considerably reduces postoperative complications and holds a promise to enable more radical surgery. This plastic surgery technique is aesthetic and effectively repairs speech and digestive functions, bringing improvement to the patients’ quality of life and social adaptation.
Background. Oral mucosal cancer is the most prevalent squamous cell cancer of head and neck, with 6,723 cases registered in Russia, including 94 per Volgograd Region, in 2018. A high tumour advancement and complex topography of the surgical area result in extensive soft-tissue defects and impaired swallowing, chewing and speech.Aim. Efficacy assessment of submental myodermal flap application in buccal reconstruction after extended combined oncological resections.Materials and methods. Submental myodermal flap was used as a buccal reconstruction technique in 112 patients aged 42 to 75 years during 2015–2020. Surgery for primary tumour was performed in 88 cases, and in 24 — for recurrence after radiotherapy or surgical excision.Results and discussion. A six-year experience of the submental myodermal flap usage in reconstructive surgery allowed evidently wider indications for extensive oral resection combined with extended, also bilateral, lymphadenectomy. Clinical records on the technique application in primary and recurrent cancer are presented.Conclusion. The submental myodermal flap technique in combination with extended or extended combined surgery for oral mucosal cancer notably increases the tumour resectability at this location and improves function restore in patients. The method widens indications for higher-volume operative aid, considerably reduces postoperative complications and holds a promise to enable more radical surgery. This plastic surgery technique is aesthetic and effectively repairs speech and digestive functions, bringing improvement to the patients’ quality of life and social adaptation.
1 Кафедра онкологии и лучевой диагностики, Таджикский государственный медицинский университет им. абуали ибни Сино, Душанбе, Республика Таджикистан 2 отделение хирургии опухолей верхних дыхательно-пищеварительных путей, Российский онкологический научный центр им. н.н. Блохина, Москва, Российская федерация В статье представлен обзор современной литературы, посвящённой заболеваемости, смертности, эволюции реконструктивно-восстановительных операций и алгоритму их применения при раке органов головы и шеи. Отражены результаты проведённых рандомизированных исследований по хирургическому лечению рака головы и шеи и проблемы, связанные с реабилитацией и качеством жизни этих больных. В частности, приведён опыт ведущих специалистов в области реконструктивно-восстановительных операций при опухолях отдельных локализаций. Проанализировано влияние одномоментной пластики на качество жизни больных. Сравнение результатов применения лоскута большой грудной мышцы и свободного лоскута из переднебоковой поверхности бедра показало, что частота осложнений во втором случае намного меньше. Изучена эффективность паллиативных операций с одномоментной реконструкцией свободными лоскутами и лоскутами на ножке у пациентов с местнораспространённым раком головы и шеи. Ключевые слова: местнораспространённый рак, голова и шея, реконструкция, лоскуты, реабилитация, качество жизни.Для цитирования: Сангинов ДР, Мудунов АМ, Юлдошев РЗ, Базаров НИ, Ниязов ИК, Сафарзода НА. Реконструктивно-восстановительные операции и вопросы качества жизни больных с местнораспространённым раком головы и шеи. Вестник Авиценны. 2019;21(1):165-72. Available from: http:// dx.The article presents an overview of modern literature on the incidence, mortality, evolution of reconstructive and plastic operations and the algorithm of their application in cancer of the organs of the head and neck. The results of randomized studies on the surgical treatment of head and neck cancer and the problems related to rehabilitation and quality of life of these patients are reflected. In particular, the experience of leading experts in the field of reconstructive surgeries for tumors of individual localizations is given. The influence of one-stage plastics on the quality of life of patients is analyzed. Comparison of the results of the application of the pectoralis major myocutaneous flap and the anterolateral thigh free flap showed that the frequency of complications in the second case is much less. The effectiveness of palliative operations with simultaneous reconstruction with free and pedicled flaps in patients with locally advanced head and neck cancer was studied. Information about the source of support in the form of grants, equipment, and drugsThe authors did not receive financial support from manufacturers of medicines and medical equipment.
To date, dental implantation is the most common routine way to restore the continuity of dentition. Additional bone augmentation surgery is required in 50-80% of patients. In order to improve the results and reduce the risks of osseointegration, denudation and rejection of bone autografts, various ways of correcting the deficiency of soft tissues of the alveolar ridge are proposed, which include the use of free soft-woven autografts, the low efficiency of which is due to a high shrinkage coefficient.The purpose of the study: to test an experimental model of a vascularized muco-periosteal flap to eliminate the volume deficit of the soft tissues of the alveolar ridge.Material and methods. On the basis of the vivarium of the Stavropol State Agrarian University (StSAU), 15 biological mannequins (heads of female dwarf pigs) were subjected to a pilot experimental study. The study was conducted in accordance with the decision of the local Ethics Committee of the StSAU, as well as the provision of the World Convention on the Protection of Animals and the Procedure for the Treatment of Experimental Animals adopted by the Helsinki Council in 2002.Results. In the course of the study, the technical stages of the tested intervention were clarified, the metric parameters of the elimination of defects of the alveolar ridge were determined.Conclusion. The results obtained will make it possible to eliminate extended soft tissue defects of the alveolar ridge by increasing the possibility of tissue sampling in the donor bed in a volume not less than 3 times greater than the intake of free palatine flaps.
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