Presentation and surgical outcome of oral malignancy at tertiary care centre

Abstract

Aim: to study etiological factors, clinical presentation and surgical outcome in oral malignancy.Materials and Methods: This study was done from April 2019 to march 2020 a total of 9 cases of oral malignancy who underwent surgery for oral malignancy were included. Patients who underwent other modality of treatment, or refused surgery were excluded from study. In our study all patient who presented with oral lesion underwent preoperative biopsy from oral cavity lesion to confirm diagnosis, Indirect laryngoscopy, CT scan Head and neck, CT Chest for metastatic workup preoperatively.Results: Out of 9 cases 7 were male and 2 were female with male to Female ratio 3.5:1. The age of the patient ranged between 30-70 years.All the 7 (77.7%) male patients had the history of chewing tobacco and 4 (44.4%) males having both tobacco and alcohol consumption habit.All 9 (100%) cases presented with growth in the oral cavity. Difficulty in chewing, trismus, difficulty in speech, palpable cervical lymph nodes were other presenting symptoms in cases.All the cases underwent preoperative biopsy. Out of 9 cases 8 (88.8%) cases were of squamous cell carcinoma in which one case of SCC of maxillary sinus. Rest of them were SCC of oral cavity, in which 3 cases were of ca tongue and 3 case of ca cheek, 1 case of gingiva. One (11.1%) of the case which was turned out as ameloblastoma of the mandible on preoperative biopsy.5 (55.5%) patients underwent commando procedure with pectoralis major myo cutaneous flap. One patient underwent maxillectomy, one underwent hemi mandibulectomy,2 patients underwent hemi glossectomy. In our study most common complication was wound infection (22.2%) followed by bleeding, wound dehiscence, pulmonary embolism. Margins were free in all resected specimen.8 (88.8%) patients were referred for post op radiotherapy. one (11.1%) patient died on post op day 3 due to acute pulmonary embolism.Conclusion: Early diagnosis and complete surgical excision is the key to good prognosis and survival, multidisciplinary team is absolutely essential to ensure a favourable outcome.