Oral Resection and Reconstruction (Oral Cancers)
Oral cancers are the most common head neck cancers in Indian men & third most in women. The most common sites are tongue and gingivobuccal sulcus followed by buccal mucosa and alveolus. Surgery remains the main stay treatment with wide local excision of lesion with 1-1.5 cm unstretched margin circumferentially. Underlying muscle or bone is excised if there is direct tumor extension or deep margin is threatened. Overlying skin and muscle is generally excised to achieve negative surgical margins.
Goals of Oral Cancers Treatment
- Maximizing cure rates
- Preserving function
- Cost effective treatment
- Minimize sequelae
- Surgical resection with appropriate immediate reconstruction
Reconstruction of Oral Cavity is an important component of oral cancer surgery. Reconstruction does not mean simply closure of oral defect. Reconstruction is needed to restore functional and aesthetic loss in oral cavity. Currently Microvascular Reconstruction is the GOLD STANDARD for oral reconstruction. Principle of Reconstruction is to replace tissue for tissue, form for form and size for size
52 year old female presented with an infiltrative growth over lateral border of tongue. She underwent hemiglossectomy and neck dissection. Reconstruction of tongue was done with Radial Artery Microvascular Flap from left forearm. Microvascular flap reconstruction allows for better speech and swallowing function after glossectomy compared to bulky pedicled flaps.
HEMIGLOSSECTOMY & RADIAL ARTERY FREE FLAP RECONSTRUCTION
66 year old gentleman presented with in infiltrative growth over lower gums (central arch) with cervical lymph node enlargement. The patient underwent composite resection with bilateral neck dissection. Bone reconstruction was done with microvascular free fibula flap from leg. Free Fibula reconstruction is the procedure of choice for central arch lesions as it allows for maintaining the contour of chin, mobility of tongue and swallowing reflex.
ARCH MANDIBULECTOMY WITH FREE FIBULA RECONSTRUCTION
At Jaypee Hospital Noida, Surgical Oncology and Reconstructive Surgery Department routinely performs these type of surgeries. Dr Ashish Goel Director Surgical Oncology, at Jaypee Hospital is a well known expert for surgery of oral cancer and reconstructions. He and his team regularly perform oral resections and reconstruction with microvascular free flaps. Dr Ashish has a keen interest in head and neck and breast cancer surgeries and reconstructions. He has a Fellowship in Head and Neck Oncology from University of Brescia, Italy.
Read more: Head & Neck Cancers/ Oral Cancers