Dr Syed Farhan Ali Razib, Associate Professor, Head and Neck Division, Department of ORLHNS, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2021 Jan;30(1):101-105.
Free flap reconstruction after surgical ablation of head & neck cancer greatly improve the surgical outcome. Microvascular anastomosis is an important part of Microsurgery and it is not widely practiced in every center. A retrospective review was conducted in the Head & Neck Division of Otolaryngology-Head & Neck Surgery Department, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from May 2016 to June 2017. Total 20 patients with head & neck cancer had been treated surgically between this period and 14 patients were reconstructed with free flap. The focus of this study is to establish the surgical outcome, which is more with free flap reconstruction in the patients previously diagnosed as head & neck cancer. We reconstructed 14 cases of oral cavity carcinoma (Stage IV) with the free flap. Majority cases were carcinoma involving the buccal mucosa with retromolar trigone (36%) followed by buccal mucosa (22%), buccal mucosa with lower alveolus (21%), carcinoma tongue with floor of the mouth (14%) and floor of the mouth (7%). Radial forearm freflap (RFFF) were commonly used in 10 cases (71.4%) and Anterolateral thigh flap (ALT) used in four cases (21.5%). Partial flap loss was seen in one case and wound infection occurred in another case but both were managed successfully with postoperative dressing and debridement. Microvascular free flap reconstruction can be a good choice after surgical removal of the head & neck cancer diseases and it should be practiced in every well-equipped tertiary medical center with the help of properly trained surgeon.
游离皮瓣重建术可显著改善头颈部癌症手术后的效果。微血管吻合术是显微外科的重要组成部分，但并非每个中心都广泛开展。本文回顾性分析了 2016 年 5 月至 2017 年 6 月在孟加拉国吉大港谢赫·穆吉布·医学大学（BSMMU）耳鼻喉科头颈外科头颈部肿瘤病房接受治疗的 20 例头颈部癌症患者的临床资料，其中 14 例患者接受游离皮瓣重建术。本研究的重点是评估游离皮瓣重建术对头颈部癌症患者的手术效果。我们使用游离皮瓣重建了 14 例口腔癌（IV 期）患者，其中颊黏膜伴磨牙后三角（36%）、颊黏膜（22%）、颊黏膜伴下牙槽（21%）、舌癌伴口底（14%）和口底（7%）为常见发病部位。10 例（71.4%）患者采用桡侧前臂游离皮瓣（RFFF），4 例（21.5%）患者采用股前外侧游离皮瓣（ALT）。1 例出现部分皮瓣坏死，1 例发生伤口感染，但均通过术后换药和清创成功治愈。游离皮瓣重建术是头颈部癌症手术后的一种较好选择，应在每一个设备齐全的三级医疗中心开展，并在经过适当培训的外科医生的帮助下进行。
