Clinical course and evaluation of shape and function after reconstruction using various pedicle flaps for oral and maxillofacial defects

Abstract

In the past 7 years, reconstruction using various pedicle flaps for oral and maxillofacial defects, was carried out for 40 patients. Pectoralis major myocutaneous, deltopectoral and scalp-forehead flaps for large defects, and sternocleidomastoid, cervical island skin and palatal flaps for moderate defects were indicated. As for results, most of the flaps used at the reconstructed site for the defects of soft tissue repaired the shape and patients were satisfied. However, the recovery of functions concerning speech, swallowing or mastication was not always successful with the larger defects, especially after the reconstruction for defects of tongue, floor of the mouth, cheek and mandible for which mandibular reconstruction was performed. It was pointed out that the main causes for less tongue mobility were due to scar contracture after reconstruction, and difficulty of mandibular reconstruction due to postoperative infection were associated factors. Accumulated survival rate of patients for 5 years was 62.6%, in which 38 advanced malignant tumors were reconstructed following surgery. In the clinical course after reconstruction, patients with primary tumors experienced much better results than those with secondary tumors.