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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2023; 27(01): e32-e42
DOI: 10.1055/s-0042-1751001
Original Research

Pedicled Flaps versus Free Flaps for Oral Cavity Cancer Reconstruction: A Comparison of Complications, Hospital Costs, and Functional Outcomes

Pichit Sittitrai 
1   Department of Otolaryngology, Chiang Mai University hospital, Chiang Mai, Thailand
,
Donyarat Ruenmarkkaew 
1   Department of Otolaryngology, Chiang Mai University hospital, Chiang Mai, Thailand
,
Hanpon Klibngern 
1   Department of Otolaryngology, Chiang Mai University hospital, Chiang Mai, Thailand
› Author Affiliations Funding The author(s) received no financial support for the research, authorship, and/or publication of the present article.
We received no specific grant from any funding agency, commercial or not-for-profit sectors, and we have no conflicts of interest to disclose.
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Abstract

Introduction Free flaps have been the preferred method for reconstruction after resection of oral cavity cancer. However, pedicled flaps remain valuable alternatives in appropriate settings.

Objective The main objective of the present study was to compare surgical complications, hospital costs, and functional outcomes of oral cavity cancer patients who underwent soft tissue reconstruction with pedicled flaps or free flaps.

Methods A total of 171 patients were included in the study. Ninety-eight underwent reconstruction with a pectoralis major, submental, temporalis, or supraclavicular pedicled flap, and in 73 patients, a radial forearm or anterolateral thigh free flap had been used. The cases were retrospectively reviewed, and a comparative analysis was carried out between the two groups.

Results Recipient site and flap complications, speech, and swallowing functions did not differ between groups, but donor site complications, operative time, hospital stay, and costs were significantly reduced in the pedicled flap group compared with the free flap group. However, the pectoralis major flap reconstruction resulted in a more inferior swallowing function than the free flap reconstruction.

Conclusions With comparable complications and functional outcomes, while decreasing in costs, pedicled flaps are a useful alternative to free flaps in oral cavity cancer reconstruction. However, in an extensive defect (> 70 cm2), free flaps are the reconstruction of choice for the preservation of swallowing function.

Keywords

pedicled flap - free flap - oral cancer - reconstruction


Publication History

Received: 06 October 2020

Accepted: 04 August 2021

Article published online:
11 July 2022

© 2023. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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