Capabilities of delayed microsurgical reconstruction in patients with squamous cell carcinoma of the buccal mucosa: clinical case

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Abstract

Surgical treatment of patients with locally advanced squamous cell carcinoma of the oral mucosa is a complicated problem requiring maximal surgical radicality and, at the same time, single-stage reconstruction to preserve organ function and achieve acceptable esthetic results. One of modern reconstruction techniques is the use of free flaps. Application  of  this  technique  requires  microsurgical  skills  from  the  surgeon.  unfortunately,  it  is  not  always  possible to achieve the result after single-stage postoperative defect closure. Sometimes unforeseen complications are observed: necrosis of the moved flaps, formation of large postoperative defects, orostomas, pharyngostomas. In such cases, oncologists  face  a  more  complicated  problem:  defect  reconstruction  in  the  conditions  of  pronounced  scarring  process in the intervention area, development of post-radiation fibrosis and soft tissue edema.

The presented clinical case demonstrates the capabilities of repeat microsurgical reconstruction in patients with orostoma developed after unsuccessful primary reconstruction.

About the authors

A. O. Guz

Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine

Author for correspondence.
Email: guz_a_o@mail.ru
ORCID iD: 0000-0002-8164-2261

Alexander Olegovich Guz

42 Bluhera St., Chelyabinsk 454087

Russian Federation

A. V. Garev

Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine

Email: fake@neicon.ru
ORCID iD: 0000-0002-1831-3748

42 Bluhera St., Chelyabinsk 454087

Russian Federation

D. M. Fatkullin

Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine

Email: fake@neicon.ru
ORCID iD: 0000-0002-7435-3306

42 Bluhera St., Chelyabinsk 454087

Russian Federation

A. S. Zaharov

Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine

Email: fake@neicon.ru
ORCID iD: 0000-0001-9533-4107

42 Bluhera St., Chelyabinsk 454087

Russian Federation

M. I. Sokolova

Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine

Email: fake@neicon.ru
ORCID iD: 0000-0002-9026-1153

42 Bluhera St., Chelyabinsk 454087

Russian Federation

References

  1. The state of oncological care to the population of Russia in 2021. Ed. by A.D. Kaprin, V.V. Starinsky, G.V. Petrova. Moscow: P.A. Herzen Moscow State Medical Research Institute – branch of the Federal State Budgetary Institution “NMIC of Radiology” of the Ministry of Health of Russia, 2022. (In Russ.).
  2. Musin S.I., Sultanbayev A.V., Menshikov K.V. et al. Surgical stage in sequential therapy of unresectable oral cancer T3–4bN0–3M0: evaluation of treatment results. Opukholi golovy i shei = Head and Neck Tumors 2021;11(4):41–9. (In Russ.). doi: 10.17650/2222-1468-2021-11-4-41-49
  3. Rudyk A.N., Busygin M.A., Khamidullin R.G. et al. Experience in the application of 3D imaging and printing technologies in clinical practice in the reconstruction of mandibular defects in malignant neoplasms. Povolzhskij onkologicheskij vestnik = Volga Oncological Bulletin 2017;4:25–9. (In Russ.).
  4. Gilbert R.W. Reconstruction of the oral cavity; past, present and future. Oral Oncol 2020;108:104683. doi: 10.1016/j.oraloncology.2020.104683
  5. Genden E.M., Rinaldo A., Suárez C. et al. Complications of free flap transfers for head and neck reconstruction following cancer resection. Oral Oncol 2004;40(10):979–84. doi: 10.1016/j.oraloncology.2004.01.012
  6. Iyer S., Ramu J., Krishnadas A. Secondary reconstruction of head and neck cancer defects – principles in its practice. J Maxillofacial Oral Surg 2023:22(Suppl. 1):1–9. doi: 10.1007/s12663-023-01875-x

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