A New Method for Treatment of Oral Cancer Postoperative Sialorrhea-Dermal Sling Operation

Abstract

The treatment of oral cancer is mainly of operative resection. Due to huge extent of resection, reconstructive surgery is performed at the same time to cover soft/and or bony defect. The reconstruction method was mainly of pectoralis major myocutaneous pedicle flap, forehead flap, temporalis muscle flap, deltopectoral flap, and trapezius myocutaneous flap in the past. However, due to progress in microsurgical technique, the free flap becomes preferred reconstruction method recently. Although advances in reconstruction surgery, there are still many sequelae to patients who received extensive surgery. These sequelae include poor outer appearance, and functional disturbance as dysphagia, impaired speech and drooling etc. The goal of reconstruction surgery has to consider wound closure, cosmesis, and preservation of function at the same time if possible. The sialorrhea is one of the main post-operative sequelae to the patient. We have described a new ”dermal sling operation” to improve the post-operative sialorrhea. The ”dermal sling operation” uses a strip of de-epithelized tissue containing dermis and a portion of subcutaneous fat from the flap itself to suspend the mouth angle. There were 78 patients suffered from oral cancer underwent wide excision of lesion and free flap reconstruction from December1999 to March 2001. Post-operative sialorrhea was noted in 11 patients. The ”dermal sling operation” was performed to treat the problem in 7 patients. The follow up period ranged from 3months to 19 months with good results.