Modified submental platysmal adipomyofascial flap: is it a reliable alternate reconstructive option for small- to mid-si
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HEAD AND NECK
Modified submental platysmal adipomyofascial flap: is it a reliable alternate reconstructive option for small‑ to mid‑sized defects especially in male patients with oral/oropharyngeal cancer? Abhishek Singh1 · Anshu Chopra1 · Shashank Chaudhary1 · Manikandan Venkatasubramaniyan2 · Kiran Joshi3 · Mudit Agarwal4 Received: 31 July 2020 / Accepted: 30 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To introduce modified submental platysmal adipomyofascial flap as a new and viable hairless locoregional option for reconstruction of small- to mid-sized defects after ablative surgery in oral/oropharyngeal cancer patients keeping in mind the present pandemic situation. Methods An observational retrospective study was conducted using modified submental platysmal adipomyofascial flap as a locoregional reconstructive option for both intraoral and oropharyngeal defects in early-stage oral/oropharyngeal cancer patients, from Jan 2016 to May 2020 in a tertiary care hospital. All patients in this study were male and the overall flap outcome was evaluated with post-operative follow-up. Results Out of 18 patients, in 4 patients modified submental platysmal adipomyofascial flap was used as a combination of flaps for reconstruction. Six patients (33.33%) underwent adjuvant radiation therapy/radiation chemotherapy. The long-term functions (speech and swallowing) and cosmetic outcomes were good in the majority of the patients. One patient (5.55%) had pinhole oroantral fistula. No patient had any major flap failure. Conclusion Modified submental platysmal adipomyofascial flap can be considered as a good alternative in male patients for reconstruction of small- to mid-sized oral cavity/oropharyngeal defects post-resection, especially during the prevailing pandemic crisis. It is an oncologically safe procedure with the major advantage of providing a hairless flap for oral cavity, tonsillar and BOT resection defects with lesser donor site morbidity. Keywords Submental platysmal flap · Adipomyofascial flap · Submental flap · Locoregional flap * Abhishek Singh [email protected] Anshu Chopra [email protected] Shashank Chaudhary [email protected] Manikandan Venkatasubramaniyan [email protected] Kiran Joshi [email protected] Mudit Agarwal [email protected] 1
Head and Neck Oncology, RGCIRC, Rohini, Delhi, India
2
Surgical Oncology, RGCIRC, Rohini, Delhi, India
3
Head and Neck Unit II, RGCIRC, Rohini, Delhi, India
4
Head and Neck Surgical Oncology, RGCIRC, Rohini, Delhi, India
Introduction Oral cavity cancer is the sixth most common cancer worldwide and comprises 30% of all head and neck cancers [1]. Most tumours of the oral cavity are squamous cell carcinomas (SCC), but other histological types such as minor salivary gland carcinomas, lymphomas and melanomas may also be seen rarely [2]. Surgery has been the mainstay for primary management of oral cavity cancer, while radiotherapy is offered post-operatively to patients at h
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