Esthetic and functional surgery and reconstruction after oral cancer ablation

Ahn,  Kang-Min

doi:2014.52.10.615

J Korean Dent Assoc > Volume 52(10); 2014 > Article

The Journal of The Korean Dental Association 2014;52(10):615-622.
DOI: https://doi.org/10.22974/jkda.2014.52.10.003 Published online October 31, 2014.

임상가를 위한 특집 3 - 심미-기능적인 구강암 수술과 재건

안강민

울산대학교 의과대학, 서울아산병원 구강악안면외과

Esthetic and functional surgery and reconstruction after oral cancer ablation

Kang-Min Ahn

Department of oral and maxillofacial surgery, College of medicine, University of Ulsan

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.

Key Words: oral cancer;reconstruction;facial nerve;forearm free flap;collagen;graft;