Submental Myodermal Flap in Buccal Reconstruction after Extended Combined Resection
https://doi.org/10.24060/2076-3093-2021-11-2-132-137
Abstract
Background. Oral mucosal cancer is the most prevalent squamous cell cancer of head and neck, with 6,723 cases registered in Russia, including 94 per Volgograd Region, in 2018. A high tumour advancement and complex topography of the surgical area result in extensive soft-tissue defects and impaired swallowing, chewing and speech.
Aim. Efficacy assessment of submental myodermal flap application in buccal reconstruction after extended combined oncological resections.
Materials and methods. Submental myodermal flap was used as a buccal reconstruction technique in 112 patients aged 42 to 75 years during 2015–2020. Surgery for primary tumour was performed in 88 cases, and in 24 — for recurrence after radiotherapy or surgical excision.
Results and discussion. A six-year experience of the submental myodermal flap usage in reconstructive surgery allowed evidently wider indications for extensive oral resection combined with extended, also bilateral, lymphadenectomy. Clinical records on the technique application in primary and recurrent cancer are presented.
Conclusion. The submental myodermal flap technique in combination with extended or extended combined surgery for oral mucosal cancer notably increases the tumour resectability at this location and improves function restore in patients. The method widens indications for higher-volume operative aid, considerably reduces postoperative complications and holds a promise to enable more radical surgery. This plastic surgery technique is aesthetic and effectively repairs speech and digestive functions, bringing improvement to the patients’ quality of life and social adaptation.
About the Authors
N. V. KovalenkoRussian Federation
Nadezhda V. Kovalenko — Cand. Sci. (Med.), Department of Oncology, Haematology and Transplantation, Institute of Continuing Medical and Pharmaceutical Education; Chief Physician
Volgograd, Russian Federation
A. Yu. Nenarokomov
Russian Federation
Alexander Yu. Nenarokomov — Cand. Sci. (Med.), Department of Oncology
Volgograd, Russian Federation
A. I. Ivanov
Russian Federation
Alexander I. Ivanov — Cand. Sci. (Med.), Department of Oncology, Deputy Chief Physician for Therapy
Volgograd, Russian Federation
S. Ye. Tolstopyatov
Russian Federation
Stanislav Ye. Tolstopyatov — Cand. Sci. (Med.), Department of Oncology
Volgograd, Russian Federation
V. V. Zhavoronkova
Russian Federation
Viktoria V. Zhavoronkova — Cand. Sci. (Med.), Department of Oncology
Volgograd, Russian Federation
A. G. Chukhnin
Russian Federation
Alexey G. Chukhnin — Cand. Sci. (Med.), Department of Oncology, Haematology and Transplantation, Institute of Continuing Medical and Pharmaceutical Education
Volgograd, Russian Federation
D. L. Speransky
Russian Federation
Dmitriy L. Speransky — Dr. Sci. (Med.), Prof., Department of Oncology, Haematology and Transplantation, Institute of Continuing Medical and Pharmaceutical Education
Volgograd, Russian Federation
T. F. Deviatchenko
Russian Federation
Tatiana F. Deviatchenko — Cand. Sci. (Med.), Department of Oncology, Haematology and Transplantation, Institute of Continuing Medical and Pharmaceutical Education
Volgograd, Russian Federation
References
1. Kaprin A.D., Starinsky V.V., Petrova G.V. (editors). Malignant neoplasms in Russia in 2018 (morbidity and mortality). Moscow: P.A. Herzen Moscow Research Oncology Institute — branch of the National Medical Research Centre for Radiology; 2019. 250 p. (In Russ.).
2. Rivera C. Essentials of oral cancer. Int J Clin Exp Pathol. 2015;8(9):11884–94. PMID: 26617944
3. Bray F., Ferlay J., Soerjomataram I., Siegel R.L., Torre L.A., Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. DOI: 10.3322/caac.21492
4. Saprina O.A., Azizyan R.I., Brzhezovsky V.Z., Mudunov A.M., Romanov I.S., Allakhverdiyeva G.F., et al. The use of the submental flap in reconstruction of head and neck defects. Siberian journal of oncology. 2018;17(3):51–7 (In Russ.). DOI: 10.21294/1814-4861-2018-17-3-51-57
5. Zakharov A.S., Guz A.O., Gareva A.V., Sokolova M.I. Possibilities of using a submental flap by restoration of postoperative defects in the oropharyngeal area. In: Proceedings of the First International Forum of Oncology and Radiology. Moscow; 2018. P. 175 (In Russ.).
6. Rahimov C.R., Akhundov A.A., Farzaliev I.М., Rahimli M.C., Kuliev S.E., Safarov D.A. Reconstruction of full-thickness chick defects formed after tumor removal using a modified technique for submental flap dissection. Head and Neck Tumors (HNT). 2018;8(2):27–33 (In Russ.). DOI: 10.17650/2222-1468-2018-8-2-27-33
7. Dhanuthai K., Rojanawatsirivej S., Thosaporn W., Kintarak S., Subarnbhesaj A., Darling M., et al. Oral cancer: a multicenter study. Med Oral Patol Oral Cir Bucal. 2018;23(1):e23–9. DOI: 10.4317/medoral.21999
8. Martin D., Pascal J.F., Baudet J., Mondie J.M., Farhat J.B., Athoum A., et al. The submental island flap: a new donor site. Anatomy and clinical applications as a free or pedicled flap. Plast Reconstr Surg. 1993;92(5):867–73. PMID: 8415968
9. Sumarroca A., Rodríguez-Bauzà E., Vega C., Fernández M., Masià J., Quer M., et al. Reconstruction of oral cavity defects with FAMM (facial artery musculomucosal) flaps. Our experience. Acta Otorrinolaringol Esp. 2015;66(5):275–80. DOI: 10.1016/j.otorri.2014.10.003
10. Kim D.Y., Alfadil L.O., Ahn K.M., Lee J.H. Reconstruction of thin and pliable oral mucosa after wide excision of oral cancer using a trimmed anterolateral thigh free flap as an adipofascial flap. J Craniofac Surg. 2018;29(4):e394–6. DOI: 10.1097/SCS.0000000000004404
11. Faisal M., Adeel M., Riaz S., Anwar A., Rashid A., Usman S., et al. The submental island flap in head and neck cancer. Ann Maxillofac Surg. 2018;8(2):287–91. DOI: 10.4103/ams.ams_225_18
12. Pradhan P., Samal D.K., Preetam C., Parida P.K. Summental island flap reconstruction for carcinoma of the oral cavity: experience in 30 cases. Word J Otolaryngol Head Neck Surg. 2019;5(3):65–70. DOI: 10.1016/j.wjorl.2018.03.007
13. Chen W.L., Yang Z.H., Huang Z.Q., Wang Y.Y., Wang Y.J., Li J.S. [Reverse facial artery-submental artery island myocutaneous flap for reconstruction of oral and maxillofacial defects following cancer ablation]. Zhonghua Kou Qiang Yi Xue Za Zhi. 2007;42(10):629–30. Chinese. PMID: 18215376
14. Hakeem A.H., Hakeem I.H., Wani F.J. Single-stage reconstruction of large defect of oral commissure and lips by submental artery island flap. Natl J Maxillofac Surg. 2018;9(2):222–4. DOI: 10.4103/njms.NJMS_61_16
15. Montero P.H., Patel S.G. Cancer of the oral cavity. Surg Oncol Clin N Am. 2015;24(3):491–508. DOI: 10.1016/j.soc.2015.03.006
Review
For citations:
Kovalenko N.V., Nenarokomov A.Yu., Ivanov A.I., Tolstopyatov S.Ye., Zhavoronkova V.V., Chukhnin A.G., Speransky D.L., Deviatchenko T.F. Submental Myodermal Flap in Buccal Reconstruction after Extended Combined Resection. Creative surgery and oncology. 2021;11(2):132-137. (In Russ.) https://doi.org/10.24060/2076-3093-2021-11-2-132-137