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The use of anterolateral thigh flap (ALTF) for functional tongue reconstruction with postoperative quality of live evaluati

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Krakowczyk Ł. , Maciejewski A. , Szymczyk C. , Wierzgoń J. , Półtorak S.

Polish Journal of Surgery

2015

tom 87(8)

384-388

The use of microsurgery for oral reconstruction of cancer patients, has become standard treatment in restoring oral function. The free anterolateral thigh flap is one of the most preferred options in reconstruction after total, subtotal or hemiresection of the tonque due to squamous cell cancer. The aim of the study was to present the reconstructive method using anterolateral thigh free flap with evaluation of quality of live. Material and methods. Clinical material includes 46 consecutive patients with tongue cancer, who underwent complex surgical treatment between 2009 and 2011. There were 36 males and 10 females and the M: F ratio was 3.6: 1. All of them were reconstructed using the anterolateral thigh free flap. The quality of life was evaluated 6 months after completing the treatment, based on postoperative functional and aesthetic status. Results. The overall flap survival rate was 96%. Surgical complications were observed in 8 patients (17%). Donor site was closed primarly in 42 cases and in remaining 4 skin graft was required. In all 46 cases understandable speech and return to unrestricted diet mastication and swallowing were achieved. The mean follow-up period after treatment was 32 months. Analysis of aesthetic effects evaluated in 23 cases and shows generally very good results. According to average transformed scores the QOL can be characterized as excellent for >90, very good for 76-90, good for 51-75, moderate for 25-50 and bad for <25 points. Conclusions. Anterolateral thigh flap, with its versatility in design, long pedicle with a suitable vessel diameter, low donor site morbidity, and very good aesthetic effects, could be the ideal flap for functional tongue reconstruction.

Czerniaki złośliwe regionu głowy i szyi w materiale Kliniki Chirurgii Onkologicznej i Rekonstrukcyjnej Centrum Onkologii IMSC w Gliwicach

86%

Krakowczyk Ł. , Maciejewski A. , Grajek M. , Szymczyk C. , Wierzgoń J. , Jędrzejewski P. , Półtorak S.

tom 64(7)

55-59

Introduction: About 25% of melanomas are localized in head and neck skin, and this particular localization is most diffi cult to treat, and the prognosis is less favorable. The depth of melanoma infi ltration (Clark and Breslau grade) into the skin is the main factor of local advancement of the disease. Surgical treatment is an essential therapeutic modality in patients with melanoma. Aim: The aim of this study was to evaluate results of our surgical treatment of melanomas in head and neck localisation, treated from 1997 to 2007 in Department of Oncological and Reconstructive Surgery in Center of Oncology IMSC in Gliwice. Material: We analysed group of 47 patients (aged 26 to 75 years, mean 49), treated by surgical excision of malignant melanoma in the head and neck region. Most of the patiens required to use free fl aps or skin graft technique to close posexcisional defect, on basis of clinical considerations. Results: The 5-year total survival for all patients was 62% and were dependent on depht of melanoma infi ltration and regional lymph node metastasis. The signifi cant prognostic factors were: localization of primary focus, local progression of disease, free microscopical excision margins sex and age. Conclusions: Prognosis in the patients with melanoma of the head and neck is unreliable and dependent on local advancement of disease and localization of primary focus. Surgical treatment is an essential therapeutic modality in patients with melanoma. Adiuvant radiotherapy after surgical treatment of melanoma of the head and neck is intended for the patiens with high risk of local or regional recurence of disease.