Summary Reconstruction of the oral floor by suture of the platysma and digastric muscle:

Abstract

Fifteen patients with oral and oropharyngeal cancer who underwent en-bloc resection with subsequent reconstruction of the oral floor by suture of the platysma and digastric muscle without free flap were reviewed. We analyzed the treatment method, clinical course, complications and quality of speech by the 10-point scoring system of Hirose. En-bloc continuous resection of the primary lesion and neck dissection were performed by the pull-through procedure or commando operation. We separated the excised cervical wound and oral cavity by suturing between the platysma and the digastric muscle. The primary lesion was located on the oral tongue in 8 patients, on the lower gum in 4 patients, on the oral floor in 2 patients and on the tonsillar f ossa in 1 patient. The patients consisted of 13 males and 2 females, with ages ranging from 28 to 81 years and a mean age of 63 years. Tracheostomy was performed in 6 patients. Five patients with lower gum or oral floor cancer underwent mandibulectomy. Two patients had received radiation for previous head and neck cancers. The mean operative time was 290 minutes. The mean volume of blood loss was 227ml. Complications occurred in 6 patients. Local small abscesses occurred in 3 patients, mild laryngeal edema occurred in 1 patient, mild laryngeal edema and a fistula occurred in 1 patient, and aspiration pneumonia occurred in 1 patient. The mean period until oral intake was 15 days. Speech intelligibility was excellent in 14 patients and moderate in 1 patient. This method is useful and effective. In advanced oral or oropharyngeal cancer requiring reconstruction by free flap, we partially use this method. But for better functional improvement, exclusive use of a free flap is much better. The indication of this method should be carefully decided.