Process of radical resection for advanced buccal cancer and the 'sandwich' technique for craniomaxillofacial defect repair using an anterolateral thigh chimeric myocutaneous flap

Abstract

Thorough radical surgery improves the survival rate of patients with advanced buccal cancer, and proper restoration can reduce complications and improve quality of life. To meet tissue the requirements of the recipient area, we proposed a modified 'sandwich' technique, using an anterolateral thigh (ALT) chimeric myocutaneous flap. In total, 120 patients were randomly divided into two groups of 60, treated using either the 'sandwich' technique or the conventional method. Perioperative recovery was recorded postoperatively. Additionally, postoperative function, appearance, and quality of life were regularly evaluated during the postoperative follow-up. The 5-year overall survival rates were 58.33 % and 53.33 % in the 'sandwich' and conventional groups, respectively (p = 0.50). The 'sandwich' technique was superior to the conventional method in terms of postoperative complications, including wound infection, prolonged wound healing time, titanium plate exposure, reoperation, and postoperative function, including degree of mouth opening, oral alimentation interval, decannulation, appearance, and postoperative quality of life (all p < 0.01). No significant difference was observed in lower extremity function between the two groups (p = 0.48). The rational application of the 'sandwich' technique using the ALT chimeric musculocutaneous flap is advantageous because of the characteristics of the various tissues - it is practical, economical, and effective.

Keywords: Myocutaneous flap; Postoperative complications; Quality of life; Wound healing; Wound infection.