The Journal of the Korean dental association (대한치과의사협회지)

The Korean Dental Association (대한치과의사협회)
권호 표지

Esthetic and functional surgery and reconstruction after oral cancer ablation

임상가를 위한 특집 3 - 심미-기능적인 구강암 수술과 재건

  • Ahn, Kang-Min (Department of oral and maxillofacial surgery, College of medicine, University of Ulsan)
  • 안강민 (울산대학교 의과대학, 서울아산병원 구강악안면외과)
  • Received : 2014.08.13
  • Accepted : 2014.09.30
  • Published : 2014.10.01
Download PDF
⟨ Previous Next ⟩

Abstract

Oral cancer ablation surgery results in tissue defects with functional loss. Accompanying neck dissection results in facial nerve weakness and dysmorphic changes. To minimize the complications after oral cancer surgery, accurate dissection without damaging facial nerve and vital structures are mandatory. Marginal mandibular branch of facial nerve should be dissected or contained in the superficial layer of deep cervical fascia to minimized facial palsy after operation. Reconstruction after cancer ablations is routine procedures and free flap reconstruction is the most commonly used. Radial forearm free flap is the most versatile flap to reconstruct soft tissue defects and it is easy to design according to the defect size and shape. However, donor site scar and secondary skin graft from thigh result in unesthetic and cumbersome wounds. Double layered collagen graft in the donor site could reduce secondary donor site for skin graft. In conclusion, oral and maxillofacial surgeon should know the exact anatomy of the face and neck during neck dissection. Radial forearm free flap is most versatile flap for soft tissue reconstruction and double collagen graft can reduce postoperative scar and there is no need for secondary skin graft.

Keywords

References

  1. Krishnamurthy A, Ramshankar V. Early stage oral tongue cancer among non-tobacco users--an increasing trend observed in a South Indian patient population presenting at a single centre, Asian Pac J Cancer Prev 2013;14:5061-5. https://doi.org/10.7314/APJCP.2013.14.9.5061
  2. Lee SY, Cho NH, Choi EC et al. Relevance of human papilloma virus (HPV) infection to carcinogenesis of oral tongue cancer, Int J Oral Maxillofac Surg 2010;39:678-83. https://doi.org/10.1016/j.ijom.2010.03.014
  3. Hino S, Hamakawa H, Miyamoto Y et al. Effects of a concurrent chemoradiotherapy with S-1 for locally advanced oral cancer, Oncol Lett 2011;2:839-43.
  4. Brown L, Rieger JM, Harris J, Seikaly H. A longitudinal study of functional outcomes after surgical resection and microvascular reconstruction for oral cancer: tongue mobility and swallowing function, J Oral Maxillofac Surg 2010;68:2690-700. https://doi.org/10.1016/j.joms.2010.05.004
  5. 유상일, 안강민. 구강암 환자의 재건술, 대한치과의사협회지 2010;48:514-21.
  6. Baker DC, Conley J. Avoiding facial nerve injuries in rhytidectomy. Anatomical variations and pitfalls, Plast Reconstr Surg 1979;64:781-95. https://doi.org/10.1097/00006534-197912000-00005
  7. Dingman RO, Grabb WC. Surgical anatomy of the mandibular ramus of the facial nerve based on the dissection of 100 facial halves, Plast Reconstr Surg Transplant Bull 1962;29:266-72. https://doi.org/10.1097/00006534-196203000-00005
  8. Holmes JD. Neck dissection: nomenclature, classification, and technique, Oral Maxillofac Surg Clin North Am 2008;20:459-75. https://doi.org/10.1016/j.coms.2008.02.005
  9. Akyurek M, Safak T. Direct closure of radial forearm free-flap donor sites by double-opposing rhomboid transposition flaps: case report, J Reconstr Microsurg 2002;18:33-6. https://doi.org/10.1055/s-2002-19707
  10. Murray RC, Gordin EA, Saigal K et al. Reconstruction of the radial forearm free flap donor site using integra artificial dermis, Microsurgery 2011;31:104-8. https://doi.org/10.1002/micr.20833
  11. Wax MK, Winslow CP, Andersen PE. Use of allogenic dermis for radial forearm free flap donor site coverage, J Otolaryngol 2002;31:341-5. https://doi.org/10.2310/7070.2002.34423
  12. Choi JY, Kim SH, Oh GJ et al. Management of defects on lower extremities with the use of matriderm and skin graft, Arch Plast Surg 2014;41:337-43. https://doi.org/10.5999/aps.2014.41.4.337
  13. Greenwood JE, Mackie IP. Neck contracture release with matriderm collagen/elastin dermal matrix, Eplasty 2011;11:e16.
  14. Jeon H, Kim J, Yeo H et al. Treatment of diabetic foot ulcer using matriderm in comparison with a skin graft, Arch Plast Surg 2013;40:403-8. https://doi.org/10.5999/aps.2013.40.4.403
  15. Ryssel H, Germann G, Kloeters O et al. Dermal substitution with Matriderm((R)) in burns on the dorsum of the hand, Burns 2010;36:1248-53. https://doi.org/10.1016/j.burns.2010.05.003