Reconstruction of the tongue and floor of the mouth using mucomuscular cheek flaps after oral cancer resection

Surgery is the main method of treatment of patients with non-generalised resectable malignant neoplasm of the oral cavity. After the removal of the tumor, defects are formed, for the removal of which various types of plastic materials are used. Objective. Evaluation of the results of reconstruction of the tongue and floor of the mouth with a cheek mucomuscular flap after tumor removal. Material and methods. Seventeen patients (aged 59±9 years) underwent surgical treatment with defect reconstruction using mucomuscular cheek flaps based on the facial artery at the P.A. Herzen Moscow Oncology Research Institute. In four cases, the flaps were rotated in the oral cavity, while in 13 cases tunnel flaps were formed, including three patients who received contralateral flaps. Results. R0 surgical resection was achieved in 16 cases, while R1 resection was performed in one case. Nine patients underwent adjuvant radiotherapy with a dose of 61.6±3.8 Gy. The one-year disease-free survival was 92.6%. Flap necrosis occurred in one case on the second day after surgery. One patient (6.9%) had flap venous insufficiency with marginal necrosis. Limited mouth opening was observed in 5 cases (29.4%) due to cicatricial deformation at the donor site. Conclusion. The mucomuscular cheek flap demonstrates excellent anatomical and functional outcomes in the reconstruction of the tongue and floor of the mouth following minor resections, utilizing morphologically identical tissues, with minimal donor site damage and a low complications rate.