gms | German Medical Science

Introduction: Advanced oral cancer is a mutilating disease with poor prognosis. It is preferably treated surgically with postoperative radiotherapy. Surgical resection, however, leaves large, sometimes composite defects requiring a variety of reconstructive options.

Methods: We present our experience with 4 cases of advanced cancer of the tongue and floor of the mouth treated with hemiglossectomy, total resection of the oral tongue, total glossectomy, and total glossectomy with resection of the central part of the mandible, in all cases without laryngectomy. The neck was addressed in all cases. For reconstruction we used pectoralis, composite rib-pectoralis major flap and radial forearm flap.

Results: There were no complications, except for a partial distal flap necrosis in one of the cases with pectoralis major flap. Function was best for more limited resections and with the use of free flap, however the pectoralis major flap proved to be reliable and even as composite flap.

Conclusions: The availability of reconstructive options is a requirement for the surgical treatment of those advanced, but still resectable tumours of the oral cavity and is maintaining the slightest chance for survival with decent functional results.