Masseter muscle flap for reconstruction of intra-oral defects in patients with early cancer of posterior-inferior parts of the oral cavity
Introduction: Early carcinomas of the oral cavity in the posterior-inferior regions poses a challenge for reconstruction due to the lack of muscle support underneath and the limited space available to use some of the frequently-used flaps. Objective: This study was done to evaluate the efficacy of t...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | Brazilian Journal of Otorhinolaryngology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1808869420302007 |
| _version_ | 1811211397101518848 |
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| author | B.C. Rajani Hoda Nadimul Ghosh Subhabrata K.S. Sabitha Annavarjula Vinitha B. Vasantha Dhara |
| author_facet | B.C. Rajani Hoda Nadimul Ghosh Subhabrata K.S. Sabitha Annavarjula Vinitha B. Vasantha Dhara |
| author_sort | B.C. Rajani |
| collection | DOAJ |
| description | Introduction: Early carcinomas of the oral cavity in the posterior-inferior regions poses a challenge for reconstruction due to the lack of muscle support underneath and the limited space available to use some of the frequently-used flaps. Objective: This study was done to evaluate the efficacy of the superiorly based masseter muscle flap in reconstruction of intra-oral post- ablation defects in patients with early oral carcinoma of the posterior-inferior part of the oral cavity. Methods: A superiorly based masseter muscle flap were used to reconstruct the post-surgical intra- oral defect in 60 patients with early squamous cell carcinoma (T < 4 cm) of the posterior-inferior part of the oral cavity. The patients were followed up at 1-week and 1-month postoperatively to check for flap viability, complications, change in mouth opening and deviation of the mandible on mouth opening. To rule out any recurrence in the oral cavity masseter flaps, the patients were followed up for 1 year. Results: The flap was viable in all patients and underwent mucosalization. 7/60 patients had postoperative infections, while 2/60 patients developed an oro-cutaneous fistula which required a secondary corrective procedure. The mean ± standard deviation of change in mouth opening at 1 week postoperatively was +1.917 ± 3.36 mm, which increased to +2.633 ± 2.95 mm at 1 month after surgery. The Friedman test revealed that there was a statistically significant change in mouth opening from preoperative period to the1 week and 1 month postoperative periods (p = 0.000). Female patients showed better improvement in mouth opening postoperatively. The ipsilateral deviation of the mandible on mouth opening was between 0–5 mm in 39 patients, 5–10 mm in 17 patients and more than 10 mm in 4 patients. There were no recurrences noted in the masseter flaps used. Conclusion: The study infers that the superiorly based masseter muscle flap is a reliable method for reconstruction in early oral cancer patients yielding good functional results and acceptable cosmesis with nominal postoperative complications. |
| first_indexed | 2024-04-12T05:13:41Z |
| format | Article |
| id | doaj.art-3aef1f638b3049e6976d852860f94658 |
| institution | Directory Open Access Journal |
| issn | 1808-8694 |
| language | English |
| last_indexed | 2024-04-12T05:13:41Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Otorhinolaryngology |
| spelling | doaj.art-3aef1f638b3049e6976d852860f946582022-12-22T03:46:42ZengElsevierBrazilian Journal of Otorhinolaryngology1808-86942022-09-01885745751Masseter muscle flap for reconstruction of intra-oral defects in patients with early cancer of posterior-inferior parts of the oral cavityB.C. Rajani0Hoda Nadimul1Ghosh Subhabrata2K.S. Sabitha3Annavarjula Vinitha4B. Vasantha Dhara5Kidwai Memorial Institute of Oncology, Department of Oral Oncology, Bengaluru, Karnataka, IndiaCorresponding author.; Kidwai Memorial Institute of Oncology, Department of Oral Oncology, Bengaluru, Karnataka, IndiaKidwai Memorial Institute of Oncology, Department of Oral Oncology, Bengaluru, Karnataka, IndiaKidwai Memorial Institute of Oncology, Department of Oral Oncology, Bengaluru, Karnataka, IndiaKidwai Memorial Institute of Oncology, Department of Oral Oncology, Bengaluru, Karnataka, IndiaKidwai Memorial Institute of Oncology, Department of Oral Oncology, Bengaluru, Karnataka, IndiaIntroduction: Early carcinomas of the oral cavity in the posterior-inferior regions poses a challenge for reconstruction due to the lack of muscle support underneath and the limited space available to use some of the frequently-used flaps. Objective: This study was done to evaluate the efficacy of the superiorly based masseter muscle flap in reconstruction of intra-oral post- ablation defects in patients with early oral carcinoma of the posterior-inferior part of the oral cavity. Methods: A superiorly based masseter muscle flap were used to reconstruct the post-surgical intra- oral defect in 60 patients with early squamous cell carcinoma (T < 4 cm) of the posterior-inferior part of the oral cavity. The patients were followed up at 1-week and 1-month postoperatively to check for flap viability, complications, change in mouth opening and deviation of the mandible on mouth opening. To rule out any recurrence in the oral cavity masseter flaps, the patients were followed up for 1 year. Results: The flap was viable in all patients and underwent mucosalization. 7/60 patients had postoperative infections, while 2/60 patients developed an oro-cutaneous fistula which required a secondary corrective procedure. The mean ± standard deviation of change in mouth opening at 1 week postoperatively was +1.917 ± 3.36 mm, which increased to +2.633 ± 2.95 mm at 1 month after surgery. The Friedman test revealed that there was a statistically significant change in mouth opening from preoperative period to the1 week and 1 month postoperative periods (p = 0.000). Female patients showed better improvement in mouth opening postoperatively. The ipsilateral deviation of the mandible on mouth opening was between 0–5 mm in 39 patients, 5–10 mm in 17 patients and more than 10 mm in 4 patients. There were no recurrences noted in the masseter flaps used. Conclusion: The study infers that the superiorly based masseter muscle flap is a reliable method for reconstruction in early oral cancer patients yielding good functional results and acceptable cosmesis with nominal postoperative complications.http://www.sciencedirect.com/science/article/pii/S1808869420302007Oral cancerMasseter muscle flapTrismusDeviation on mouth opening |
| spellingShingle | B.C. Rajani Hoda Nadimul Ghosh Subhabrata K.S. Sabitha Annavarjula Vinitha B. Vasantha Dhara Masseter muscle flap for reconstruction of intra-oral defects in patients with early cancer of posterior-inferior parts of the oral cavity Brazilian Journal of Otorhinolaryngology Oral cancer Masseter muscle flap Trismus Deviation on mouth opening |
| title | Masseter muscle flap for reconstruction of intra-oral defects in patients with early cancer of posterior-inferior parts of the oral cavity |
| title_full | Masseter muscle flap for reconstruction of intra-oral defects in patients with early cancer of posterior-inferior parts of the oral cavity |
| title_fullStr | Masseter muscle flap for reconstruction of intra-oral defects in patients with early cancer of posterior-inferior parts of the oral cavity |
| title_full_unstemmed | Masseter muscle flap for reconstruction of intra-oral defects in patients with early cancer of posterior-inferior parts of the oral cavity |
| title_short | Masseter muscle flap for reconstruction of intra-oral defects in patients with early cancer of posterior-inferior parts of the oral cavity |
| title_sort | masseter muscle flap for reconstruction of intra oral defects in patients with early cancer of posterior inferior parts of the oral cavity |
| topic | Oral cancer Masseter muscle flap Trismus Deviation on mouth opening |
| url | http://www.sciencedirect.com/science/article/pii/S1808869420302007 |
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