title: Composite reconstruction in advanced cancer of the mouth floor: autogenous frozen-thawed mandibular bone and free flaps.
abstract: Mandibular symphyseal resection requires composite reconstructions, often with unsatisfactory morphofunctional results. Seven patients with advanced squamous cell carcinoma of the floor of the mouth underwent block resection with immediate reconstruction, using the removed mandible treated with liquid nitrogen and covered with a free forearm flap. In all cases, the resection was radical and no major postoperative complications occurred. Two patients died in 6 months for distant metastases and regional recurrence. In the other 5 patients, no local recurrence occurred at a mean follow-up of 52 months (36-70). Immediate cosmetic and functional results were good. Of the 5 patients, 4 had late complications requiring further surgery. This technique of bone reimplantation produces no donor site morbidity, perfect immediate morphological result, and is of low cost. The free forearm flap is effective in sealing the oral cavity, though further clinical and experimental studies are necessary to reduce late local complications.
authors.affiliation: Division of Head and Neck Surgery, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy. luca.calabrese@ieo.it
authors.forename: Luca
authors.initials: L
authors.lastname: Calabrese
authors.forename: Cristina
authors.initials: C
authors.lastname: Garusi
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Giugliano
authors.forename: Mohssen
authors.initials: M
authors.lastname: Ansarin
authors.forename: Roberto
authors.initials: R
authors.lastname: Bruschini
authors.forename: Fausto
authors.initials: F
authors.lastname: Chiesa
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004210:Dissection; D005260:Female; D005927:Glossectomy; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D009060:Mouth Floor; D009062:Mouth Neoplasms / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010865:Pilot Projects; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps