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Reconstruction for Early Oral Cavity Cancer

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Difficult Decisions in Head and Neck Oncologic Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

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Abstract

Surgical extirpation has been established as the mainstay for early oral cavity cancers. This chapter reviews the evidence for reconstruction versus no reconstruction in patients undergoing surgical excision for early stage oral cavity cancer. The broad three anatomical subunits of the oral cavity are: (1) tongue and floor of mouth, (2) hard palate/inferior maxilla, and (3) gingivo-buccal and retromolar trigone region. The prevailing evidence does not conclusively support any one treatment method over another. Our algorithm for reconstruction is as follows:

  1. 1.

    For defects of the tongue involving more than 40% of tongue bulk, flap reconstruction is done to maintain swallowing function.

  2. 2.

    Where there is any floor of mouth defect, flap reconstruction is performed when there is a substantial communication of the oral cavity with the neck.

  3. 3.

    For gingivo-buccal defects, flap reconstruction is preferred to prevent microstomia.

  4. 4.

    For hard palate and inferior maxilla defects, our preference is flap reconstruction for any defect size.

When reconstruction is chosen, graft or flap choice should be based on defect size, depth, and the need for obliteration of dead space.

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Author information

Authors and Affiliations

  1. Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore, Singapore

    Weihao Liang & Adrian S. H. Ooi

Authors
  1. Weihao Liang
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  2. Adrian S. H. Ooi
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Correspondence to Adrian S. H. Ooi .

Editor information

Editors and Affiliations

  1. Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, University of Chicago, Chicago, IL, USA

    Zhen Gooi

  2. Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, University of Chicago, Chicago, IL, USA

    Nishant Agrawal

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Liang, W., Ooi, A.S.H. (2019). Reconstruction for Early Oral Cavity Cancer. In: Gooi, Z., Agrawal, N. (eds) Difficult Decisions in Head and Neck Oncologic Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-030-15123-2_26

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  • DOI: https://doi.org/10.1007/978-3-030-15123-2_26

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-15122-5

  • Online ISBN: 978-3-030-15123-2

  • eBook Packages: MedicineMedicine (R0)

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