Discussion on reconstruction of the postoperative defect after oral floor carcinoma resection

Abstract

To explore the reconstruction approaches and indications in repairing of postoperative defect after resection of oral floor carcinoma. To review the clinical data of 106 patients with oral floor carcinoma treated by radical resection with simultaneous reconstruction in the Department of Head and Neck Surgery at our hospital from July 2003 to March 2013, and to evaluate the advantages and disadvantages of various repair methods. The patients were followed up for 2 months to 10 years. Their 3-year survival rate was 63.6% (42/66) and 5-year survival rate was 57.7% (30/52). One case had sternocleidomastoid myocutaneous flap necrosis, and was successfully repaired with elective pectoralis major myocutaneous flap. Another one case showed partial strap muscle flap necrosis, and the wound was well healed after debridement and dressing changes. Three cases of free flap crisis because of poor blood supply were successfully cured by flap emergency exploration. The rest were well healed. The eating and language function of the patients could meet the general needs of life. At the time of radical resection of oral floor carcinoma, an appropriate repair method should be selected according to many factors such as disease conditions, defect size, patients' physical constitution, etc. Generally, adjacent pedicle flap is not recommended. Prosthodontics membrane, free forearm flap, free anterolateral thigh flap, pectoralis major myocutaneous flap and free fibula flap can basically meet the need of repair of the postoperative defect after resection of oral floor carcinoma, therefore, are recommended.