Comparison of reconstruction outcomes of through-and-through buccal defects involving the labial commissure following tumor resection with 4 pedicled local flaps

doi:10.19438/j.cjoms.2021.02.004

Abstract

Abstract: PURPOSE: The purpose of this study was to evaluate the outcomes of reconstruction of through-and-through buccal defects involving the labial commissure following tumor resection with 4 pedicled local flaps. METHODS: This study evaluated 35 patients with buccal squamous cell carcinoma(SCC) involving the labial commissure who received Abbe-Estlander (A-EF), folded extended supraclavicular fasciocutaneous island(SFIF), folded pectoralis major muscle (PMMF), or folded extended vertical lower trapezius island myocutaneous(TIMF) flap for reconstruction of through-and-through buccal defects. The results were analyzed with SPSS 20.0 software package. RESULTS: The A-EF and SFIF group differed significantly (P<0.05) from the PMMF and TIMF groups in terms of tumor clinical stage and type of treatment. The esthetic results, orbicularis oris function, and speech function were significantly better in A-EF group than in SFIF, PMMF, and TIMF group(P<0.05). At the final follow-up, 4(80.0%) patients in A-EF group, 7(87.5%) in SFIF group, 5 (55.6%) in PMMF group, and 5(38.4%) in the TIMF group were alive with no disease; one (20.0%), 1(12.5%), 2(22.2%), and 4(30.8%) patients, respectively, were alive with disease, and 2(22.2%) patients in PMMF group and 4(30.8%) in TIMF group died of local recurrence or distant metastases between 9 and 38 months. CONCLUSIONS: A-EF is suitable for reconstructing defects of clinical stage Ⅱ disease, SFIF for clinical stage Ⅱ or Ⅲ disease, PMMF for clinical stage Ⅲ or Ⅳ, and TIMF for clinical stage rCS Ⅲ or rCS Ⅳ disease.

Key words: Cheek, Squamous cell carcinoma, Buccal defect, Pedicled local flaps, Abbe-Estlander flap, Supraclavicular flap, Pectoralis major muscle flap, Trapezius myocutaneous flap

CLC Number:

R782.2

HONG Lei, CHEN Wei-liang, YUAN Kai-fang, ZHOU Bin, CHEN Rui. Comparison of reconstruction outcomes of through-and-through buccal defects involving the labial commissure following tumor resection with 4 pedicled local flaps[J]. China Journal of Oral and Maxillofacial Surgery, 2021, 19(2): 116-120.

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