Reconstruction of anterior floor of mouth defects by the local mandible myofascial flap following cancer ablation: a pilot study.

BACKGROUND: The purpose of this study is to review our experience with the use of the local mandible myofascial (LMM) flap for anterior floor of mouth (AFOM) reconstruction following cancer ablation to assess its reliability, associated complications and functional results. METHODS: This is a retrospective analysis of 13 LMM flaps (nine patients) performed for AFOM reconstruction from March 2010 to June 2012. All patients underwent surgical resection and immediate reconstruction with LMM flaps. They were followed up for 3-30 months to evaluate the survival rate of the flaps, mobility of tongue and aesthetic outcome of the lower lip and mental region. RESULTS: All the flaps were successfully transferred. No obvious complications were found in either the AFOM or the donor region. The majority of patients resumed to a regular diet (89%, 8/9) and speech was considered as functional and/or understandable by the surgeon in all of the patients. Dental restoration was successful for 89% (8/9) of the patients. The shape and motion of the lower lip and the mental region of all patients were acceptable. CONCLUSIONS: The LMM flap is well suited for AFOM reconstruction because it is reliable, has few significant complications and allows preservation of oral function.

[Reconstruction of anterior mouth floor defects with depressor labii inferioris flap: a preliminary report].

OBJECTIVE: To investigate the method and efficacy of reconstruction of anterior mouth floor defects with depressor labii inferioris flap. METHODS: Between March 2010 and August 2011, 4 patients with cancer in the anterior part of oral floor underwent tumour resection and simultaneous reconstruction with depressor labii inferioris flap. The patients were followed up for 2 - 18 months. The survival of the flaps, mobility of tongue and esthetic outcome of lip and mental region were evaluated. RESULTS: All the flaps survived completely, tongues moved well, and functional and esthetic results were good. CONCLUSIONS: The depressor labii inferioris flaps are suitable for repairing defects of anterior oral floor.

[Reconstruction of mandibular defect caused by resection of oral carcinoma with pectoralis major myocutaneous flap and ti-plate system].

OBJECTIVE: To investigate the clinical effect of the pectoralis major myocutaneous flap and Ti-plate system in repairing mandibular defects caused by resection of oral carcinoma. METHODS: From November 2001 to February 2003, 32 patients with mandibular defect caused by resection of oral carcinoma were treated. Combined radical neck dissection with resection of gingival and mandible was performed on 11 patients with carcinoma of the lower gingival, combined radical neck dissection with glossectomy and mandibulectomy on 13 patients with carcinoma of tongue, combined radical neck dissection with resection of floor of mouth and mandible on 4 patients with carcinoma of floor of mouth, and combined radical neck dissection with resection of cheek and mandible on 4 patients with carcinoma of buccal mucosa, respectively. The defects of mandible were associated with soft-tissue component, the sizes of defect ranged from 5.5 cm x 7.6 cm to 8. 2 cm x 10.5 cm. The defects were reconstructed with 6 cm x 7 cm to 9 cm x 10 cm pectoralis major myocutaneous flaps and Ti-plate system. The effect was studied retrospectively. RESULTS: Thirty-two cases were followed for 2-19 months; 29 cases of flaps survived and 3 cases of flaps partly necrosed (10% or less of the skin paddle). The appearance of face was satisfactory in 27 patients, and slight deformity of face was observed in 5 patients. The occluding relation and masticatory function were recovered well. Opening mouth extents ranged from 2.7 cm to 3.4 cm. No temporomandibular arthrosis relating to operation was found in all cases. CONCLUSION: A combination of the pectoralis major myocutaneous flap and Ti-plate system is an ideal method for reconstruction of mandible defects associated with soft-tissue component after radical operation of oral carcinoma.

[Repair of maxillary defects by free forearm flap and titanium mesh].

OBJECTIVE: To investigate the clinical effect of free forearm flap and titanium mesh in repairing maxillary defects. METHODS: From January 2002 to November 2002, partial maxillectomy or maxillectomy were performed in 3 patients with maxillary gingival carcinoma, in 1 patient with palatine mucoepicermoid carcinoma and in 1 patient with maxillary sinus carcinoma. Maxillary defects were reconstructed with free forearm flaps ranging from 4 cm x 5 cm to 6 cm x 7 cm and titanium mesh. The effect was estimated by clinical examination, CT and nasopharyngoscope. RESULTS: Five cases were followed up 5-15 months. All the flaps were alive. Facial, alveolar process and palatal contours were restored well. Epithelium was found on the nostril surface of the titanium mesh. The functions of speech and chew were restored well. CONCLUSION: A combination of the free forearm flap and titanium mesh is an ideal method in reconstruction of maxillary defects.