Jing Ye, Xiaohua Jiang, Dan Ye and Mang Xiao*
Department of Otolaryngology, Head and Neck Surgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, ChinaFulltext PDF
Background: The common site of oral cavity and oropharyngeal cancer including maxilla, soft palate, tongue, tonsil, buccal mucosa and mouth floor. Immediate oral reconstruction is always necessary because of surgical resection lead to inevitable functional loss. It has a unique procedure, that is, to reposition the pedicle via transoral approach to recipient vessels. Sometimes the flaps pedicle could be squeezed during the transportation so that the tunnel must be expanded, which may cause extra damages. Methods: An intrathoracic tube could solve the problem. Patients with oral carcinoma underwent primary surgical resection and neck dissection without mandibulotomy, and immediate reconstruction with radial free forearm flap or superficial fascia layer were appropriate for this technique. Results: This technique based a modified intrathoracic tube allows the thin and reliable free flaps smoothly transported intraoral, decreasing the need of additional debulking procedures. Time to transport the flap as presented ranged between 3 min and 5 min. There was no loss of arterial Doppler signal. Conclusion: We utilized the intrathoracic tube for ensuring flap and pedicle orientation. What’s more, it is the prophase of our design---a guide wire-like instrument to “guide” the flap pedicle via transoral approach. Most oropharyngeal cancer patients will be benefit from it.
Oral cavity and oropharyngeal cancer; Intrathoracic tube; Free flap pedicle; Transoral approach
Ye J, Jiang X, Ye D, Xiao M. Use of the Intrathoracic Tube for Repositioning Free Flap Pedicle via Transoral Approach. Clin Surg. 2019; 4: 2618.