scholarly journals Forehead flap: a reconstructive option in selected complex defects following resection of oral cancers staged T4

2021 ◽  
Author(s):  
Deepika Kenkere ◽  
S. M. Azeem Mohiyuddin ◽  
Ravindra P. Deo ◽  
Sagayaraj A. ◽  
Kouser Mohammadi ◽  
...  
Keyword(s):  
Locally Advanced ◽  
Squamous Carcinoma ◽  
Wound Dehiscence ◽  
Oral Carcinoma ◽  
Full Thickness ◽  
Flap Reconstruction ◽  
Forehead Flap ◽  
Lower Lip ◽  
Reconstructive Option ◽  
Oral Commissure

<p class="abstract"><strong>Background:</strong> Head and neck squamous carcinoma constitutes 30% of malignancies in our region, oral carcinoma being most common among them. Most of these tumours involve lower gingivobuccal sulcus and buccal mucosa. 80% patients present with locally advanced disease. Following resection of these tumours, reconstruction of composite defects is challenging. Though microvascular free flaps are ideal in such cases, it is not always feasible due to malnutrition, peripheral vascular disease, sometimes non–availability of microvascular surgeon and financial constraints. Pectoralis major myocutaneous flap, the workhorse of reconstruction is bulky, non-pliable and cannot be advanced over intact mandible. Forehead flap in complex defects is pliable, versatile, has excellent vascularity and colour matching, easy to harvest and suitable in selected cases and as salvage flap when other flaps fail. The aim of the study was to document outcome of folded forehead flap reconstruction of complex defects following resection of T4 staged oral carcinoma.</p><p class="abstract"><strong>Methods:</strong> This retrospective study in a tertiary rural hospital included 31 patients with oral carcinoma staged T4. The patients underwent folded forehead flap reconstruction for full thickness cheek defects with some extending into oral commissure and lower lip, along with segmental or alveolar resection of mandible or maxilla.</p><p class="abstract"><strong>Results: </strong>27 patients had uneventful healing, 2 had wound dehiscence and 2 had necrosis of distal part of flap. Patients with externally rotated flap had mild trismus and patients in whom forehead flap was used to reconstruct the oral commissure had oral incompetence.</p><p class="abstract"><strong>Conclusions: </strong>Folded forehead flap is good reconstructive option in complex full thickness defects of cheek and as salvage reconstruction.</p>

scholarly journals Is reconstruction of composite defects of nose and cheek following tumor excision utilizing subunit principle the best?

2021 ◽  
Vol 7 (5) ◽  
pp. 721
Author(s):  
Viresh Arora ◽  
Faisal Ashfaq ◽  
Atif Rafique
Keyword(s):  
Wound Dehiscence ◽  
Advancement Flap ◽  
Nasal Reconstruction ◽  
Full Thickness ◽  
Lateral Migration ◽  
Forehead Flap ◽  
Nasal Defect ◽  
Alar Retraction ◽  
Simultaneous Reconstruction ◽  
Nasal Defects

<p class="abstract"><strong>Background:</strong> Composite defects of nose and cheek are best stage reconstructed with separate nose and cheek flaps to recreate a blended nose-cheek junction, achieved by cheek advancement flap for cheek and forehead flap or local grafts for the nasal defect. This article analyses whether reconstruction of defects utilizing well-known subunit principle is cosmetically the best?</p><p class="abstract"><strong>Methods:</strong> Case records of fifteen patients of nasal cancers extension into the cheek from January 2011 to December 2015 were analyzed retrospectively.</p><p class="abstract"><strong>Results:</strong> Out of fifteen patients 8 were men and 7 women, two patients had SCC, rest had BCC. Average size of defect was 4.5 cm. Modified Imre’s cheek advancement flaps was used in all to reconstruct cheek defects while paramedian forehead flap was used for nasal reconstruction in 13 patients, skin graft and nasal advancement flap in one each. Eight patients underwent single stage reconstruction while seven with full thickness nasal defects had a delayed reconstruction. 13 patients rated their final appearance as satisfactory, while surgeon rated 12 patients with well-blended nose-cheek junction as satisfactory and lateral migration of junction being unsatisfactory. Alar retraction was observed in two patients with full thickness nasal defects. Two patients who underwent inner nasal lining reconstruction developed wound dehiscence while simultaneous reconstruction of nose and cheek was performed.</p><p class="abstract"><strong>Conclusions:</strong> Subunit principle application for composite nose and cheek results in symmetrical nose-cheek junction and appears excellent technique in achieving a satisfactory aesthetic outcome. Optimal results in full thickness nasal defects are achieved where reconstructing is delayed.</p>

scholarly journals Outcome in Patients with Partial and Full-Thickness Cheek Defects following Free Flap Reconstruction—A Multicentric Analysis of 47 Cases

2020 ◽  
Vol 9 (6) ◽  
pp. 1740
Author(s):  
Stefan Janik ◽  
Rachelle Eljazzar ◽  
Muhammad Faisal ◽  
Stefan Grasl ◽  
Erich Vyskocil ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Free Flap ◽  
Functional Outcomes ◽  
Tumor Resection ◽  
Wound Dehiscence ◽  
Full Thickness ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Recipient Site ◽  
Solid Malignancies

The objective of this study was to evaluate whether the extent of tumor resection and free flap reconstruction influences functional outcome and complications in patients with solid malignancies of the cheek. Therefore, we retrospectively assessed recipient site complications and functional outcomes in 47 patients with solid malignancies of the cheek who underwent either partial (n = 30; 63.8%) or full-thickness (n = 17; 36.2%) cheek resection with free flap reconstruction. Complications occurred in 12 (70.6%) patients after full thickness resections with creation of through-and-through defects compared to 14 (70.6%) patients with partial defects (p = 0.138). Among those 26 patients (55.3%), major recipient site complications, like development of salivary fistula or free flap loss, were observed in 10 (21.3%) and 2 (4.3%) cases, respectively, while minor complications, like wound dehiscence and local infections, were found in 14 (29.8%) and 9 (19.1%) patients. Complications were noticed particularly after reconstruction of suborbital defects (69.2%; p = 0.268), of which occurrence of salivary fistulae was the most common (46.2%; p = 0.035). Similarly, functional outcomes including oral incompetence, ectropion, and trismus were not affected by the extent of resection (p = 0.766). However, oral incompetence was higher in patients with tumors originating from the oral cavity (p = 0.020) and after the performance of mandibulectomy (p = 0.003). Overall, there was no difference in functional outcome or recipient site morbidity between tumor resections resulting in full-thickness and partial defects.

Free‐flap reconstruction for full‐thickness oral defects involving the oral commissure combined with oral modiolus reconstruction using a fascial sling

Microsurgery ◽  
2019 ◽  
Vol 40 (5) ◽  
pp. 553-560 ◽  
Author(s):  
Kaoru Sasaki ◽  
Masahiro Sasaki ◽  
Junya Oshima ◽  
Yukiko Aihara ◽  
Akio Nishijima ◽  
...  
Keyword(s):  
Free Flap ◽  
Full Thickness ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Fascial Sling ◽  
Oral Commissure

The PAP Flap Breast Reconstruction: A Practical Option for Slim Patients

2021 ◽  
Author(s):  
Taehee Jo ◽  
Dong Nyeok Jeon ◽  
Hyun Ho Han
Keyword(s):  
Donor Site ◽  
Wound Dehiscence ◽  
Diep Flap ◽  
Separate Analysis ◽  
Flap Reconstruction ◽  
Average Body Mass Index ◽  
Deep Inferior Epigastric Perforator ◽  
Average Body Mass ◽  
Artery Perforator ◽  
Average Body

Abstract Background The posterior thigh-based profunda artery perforator (PAP) flap has been an emerging option as a secondary choice in breast reconstructions. However, whether a PAP flap could consistently serve as the secondary option in slim patients has not been investigated. Methods Records of immediate unilateral breast reconstructions performed from May 2017 to June 2019 were reviewed. PAP flap breast reconstructions were compared with standard deep inferior epigastric perforator (DIEP) flap breast reconstructions, and were grouped into single or stacked PAP flaps for further analysis. Results Overall, 43 PAP flaps were performed to reconstruct 32 breasts. Eleven patients underwent stacked PAP flap reconstruction, while 17 patients underwent 21 single PAP flap reconstruction. The average body mass index (BMI) of the patients was 22.2 ± 0.5 kg/m2. The results were as follows: no total loss, one case of venous congestion (2.3%), two donor site wound dehiscence cases (4.7%), and one case of fat necrosis from partial flap loss (2.3%). When compared with 192 DIEP flap reconstructions, the final DIEP flap supplied 98.1 ± 1.7% of mastectomy weight, while the final PAP flap supplied 114.1 ± 6.2% of mastectomy weight (p < 0.005), demonstrating that PAP flaps can successfully supply final reconstruction volume. In a separate analysis, single PAP flaps successfully supplied 104.2% (84.2-144.4%) of mastectomy weights, while stacked PAP flaps supplied 103.7% (98.8-115.2%) of mastectomy weights. Conclusion In our series of PAP flap reconstructions performed in low-to-normal BMI patients, we found that PAP flaps, as single or stacked flaps, provide sufficient volume to reconstruct mastectomy defects.

Neuroma of The Supraorbital Nerve Following Forehead Flap Reconstruction – Presentation and Surgical Management

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Myan Bhoopalam ◽  
Paul N. Manson ◽  
Michael Grant ◽  
Sashank K. Reddy
Keyword(s):  
Surgical Management ◽  
Flap Reconstruction ◽  
Forehead Flap ◽  
Supraorbital Nerve

Capecitabine‐Based Chemoradiotherapy with Adjuvant Capecitabine for Locally Advanced Squamous Carcinoma of the Uterine Cervix: Phase II Results

2009 ◽  
Vol 14 (8) ◽  
pp. 828-834 ◽  
Author(s):  
Efren Domingo ◽  
Vicharn Lorvidhaya ◽  
Rey de los Reyes ◽  
Teresa SyOrtin ◽  
Pimkhuan Kamnerdsupaphon ◽  
...  
Keyword(s):  
Phase Ii ◽  
Uterine Cervix ◽  
Locally Advanced ◽  
Squamous Carcinoma

scholarly journals Lip Shaving in Carcinoma Lower Lip and Reconstruction by Local Advancement Mucosal Flap Under Local Anesthesia: A Case Report

2020 ◽  
Vol 5 (8) ◽  
pp. 905-909
Author(s):  
Tareq Mohammed ◽  
Mamoon TB ◽  
Md Sirajul Islam ◽  
Md Aminul Islam ◽  
Farid Uddin Milki ◽  
...  
Keyword(s):  
Sun Exposure ◽  
Squamous Cell Carcinomas ◽  
Careful Planning ◽  
Lower Lip ◽  
Verbal Expression ◽  
Lip Reconstruction ◽  
Mucosal Flap ◽  
The Face ◽  
Extensive Surgery ◽  
Oral Commissure

The lips are one of the most important features of the face; and are functionally and aesthetically very important. It serves as border of the oral commissure, provides access to oral cavity and contributes to oral competence. It is important for verbal expression and fundamental for facial expression and overall appearance of face1 . Excessive sun exposure and tobacco use, may develop cancer. The cancer can occur anywhere along the upper or lower lip, but is most common on the lower lip. Most lip cancers are squamous cell carcinomas. Surgery is the main stay of treatment and lip shave is an established modality for superficial lesion followed by reconstruction. Extensive surgery may be necessary for larger lesion. Careful planning and reconstruction can restore eating and speaking normally, and also achieve a satisfactory appearance after surgery. Evidence supports that the concept of lip reconstruction started as early as 1000 BC in the sacred texts of great Susruta, India2 . Lip mucosa is very special and it is recommended to reconstruct the surgical defect with lip tissue whenever possible, as any other tissue is never comparable or can replace the lip tissue3 . This is the example of this presented case.

scholarly journals Distinguishing between HPV-Associated Metastatic Anal Squamous Cell Cancer and HPV-Associated Oropharyngeal Cancer

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Steven Sorscher
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Regional Lymph Node ◽  
Cell Cancer ◽  
Locally Advanced ◽  
Squamous Carcinoma ◽  
Therapeutic Implications ◽  
A Site

The histology and immunohistochemistry (IHC) of primary and metastatic diseases from a human papilloma virus- (HPV-) related anal squamous carcinoma (ASCC) would typically demonstrate the same histology as an HPV-related oropharyngeal squamous carcinoma (OPSCC). However, determining whether a site of squamous cell carcinoma represents distant metastatic ASCC versus a metastatic HPV-related metastasis from an OPSCC to a regional lymph node carries profound prognostic and therapeutic implications. A patient with a history of locally advanced ASCC treated with standard concurrent radiation therapy and chemotherapy in 2015 is described. In 2018, an enlarged supraclavicular lymph node was excised demonstrating squamous cell carcinoma and radiographic staging revealed no other areas suspicious for malignancy. Direct laryngoscopy with operating telescope and biopsies demonstrated squamous cell carcinoma at the tongue base. Described here are assays that might be considered in distinguishing between whether a focus distant from a previously identified ASCC represents metastatic disease or instead a separate primary HPV-related cancer.

Sign in / Sign up

Export Citation Format

Share Document