Transmadibular resection and reconstrution with radial forarm free flap in oropharyngeal squamous cell carcinoma – how we do it

Introduction In selected cases of oropharyngeal squamous cell carcinomas (OPSCC), a transmandibular resection and reconstruction with a radial forarm free flap (RFFF) can be a useful surgical approach to achieve clear resection margins and facilitate a functional reconstruction. In this analysis, we want to give an overwiev of our results of this complex surgery.

Methods In this retrospective study, we included all patients that underwent transmandibular resection and reconstruction with a RFFF for OPSCC from April 2019 to October 2023 in our hospital. We evaluated the postoperative complications in this cohort.

Results We included 27 patients (21 male, 6 femal) with a mean age of 63 years. There was no transplant loss. 11 patients showed complications of the surgery. There were no pseudarthrosis or instability of the mandible. Four patients needed a percutaneous endoscopic gastrostomy (PEG). In 3 of these patients, the tube could be removed afterwards. Three patients were dismissed with a tracheostoma. In 2 patients, the tracheostomy tube could be removed. Seven patients had temporarily mild internal complications.

Discussion The transmandibular resection and reconstraction with the RFFF is a good and save alternative to achieve a good oncological result. Head and neck surgeons should consider this kind of complex surgery in selected cases.

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Artikel online veröffentlicht:
19. April 2024