Introduction. Locally advanced cancer of oral mucosa and oropharynx extending to the mandible is an indication for its segmental resection. After mandible resection, especially after combined and extended radical resection of the floor of the mouth including the mandible, restoration of form and function is of primary importance for patients’ rehabilitation.
Case presentation. A 64-year-old man was diagnosed with cancer of the anterior section of the mouth floor, with metastases to neck lymph nodes, stage IV grade II (T4N1M0). Computed tomography scan identified lytic destruction of the alveolar process in the range of 32-33 teeth. The pathohistological examination diagnosed a G2 squamous cell carcinoma. A lower temporary tracheostomy was performed, with neck dissection on both sides, resection of the floor of the oral cavity with partial tongue resection, segmental mandible resection, reconstruction of the mandible with a non-vascularized iliac crest, reconstruction of the floor of the oral cavity and tongue with the radial forearm free flap. A resection template was used for segmental resection of the mandible. Long-term postoperative regional analgesia was used. During surgical treatment, it was necessary to choose the type of reconstruction to restore the shape, volume and functionality of the organ.
Conclusions. This case demonstrates good functional (restoration and preservation of chewing and swallowing) and aesthetic results when using free bone and fasciocutaneous free flaps for primary mandibular reconstruction. The use of computer-aided design/computer-aided manufacture technology improves the quality of reconstruction and minimizes the likelihood of complications.
Keywords: radial forearm free flap, cancer, swallowing, chewing, anesthesia.
Full text sources https://doi.org/10.31688/ABMU.2023.58.1.08
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Anna KUSHTA
National Pirogov Memorial Medical University, Vinnytsya, Ukraine
Address: Pirogova str., no. 56, Vinnytsya, 21018, Ukraine
Email: dr_anna9@ukr.net; Phone +38 0677903790
