Abstract
Oral cancer is among the top three cancers in India. Surgery is the recommended treatment option for early-stage and locally advanced resectable cases. The incidence of perioperative stroke in patients undergoing neck dissection for head and neck cancer is only 0.2%. In the following article, we report the first case of perioperative malignant infarct in a patient undergoing mandibular reconstruction with free fibula flap surgery for oral cancer. An eighty-year-old male diagnosed with locally advanced carcinoma of the oral cavity underwent mandibular reconstruction with free fibula flap surgery. In the perioperative period, he developed malignant infarction involving the right middle and posterior cerebral artery in the immediate postoperative period, however, it was diagnosed after 36 hours of surgery. He was managed conservatively and discharged with a favorable outcome. This case highlights the importance of clinical examination in such a case, along with the difficulties faced in examining the patient in the perioperative period.
Highlights
Oral cancer is among the top three types of cancers in India.[1]
Perioperative stroke during head and neck surgery is a devastating complication with high morbidity and mortality
The incidence of perioperative stroke in patients undergoing neck dissection for head and neck cancer is only0.2%4 which is equal to the risk of perioperative stroke in patients undergoing non-head and neck
Summary
Oral cancer is among the top three types of cancers in India.[1]. The incidence of oral cancer increases with age, fifth decade being the commonest.[2]. Case Report An eighty-year-old male patient with no relevant past medical history was diagnosed with squamous cell cancer of the oral cavity following biopsy of an ulcer on the inner side of the right cheek of one-month duration. He was assigned, T4N2M0 staging after evaluation. Thirty-six hours after the procedure, the patient developed tachycardia, a dip in sensorium with increased oxygen requirement on a facemask On examination, he was drowsy; and was not moving his left lower limb at all with extensor response on planter reflex.
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