“Sandwich” Technique For Craniomaxillofacial Defect Repair Using The Alt

Radical resection is a key step in the treatment of advanced buccal cancer. Improper restoration of the complicated defects of advanced buccal cancer resection often leads to serious complications. To meet the tissue requirements of the recipient area, we propose the modified “sandwich” technique using the anterolateral thigh (ALT) chimeric myocutaneous flap. Through a three-dimensional design, we made full use of the flap to reasonably repair the defect. Data from 120 patients with locally advanced buccal cancer were collected; 60 patients were treated using the conventional method, and 60 patients were treated using the “sandwich” technique. The perioperative recovery of patients was recorded after the operation. In addition, postoperative function, appearance changes, and quality of life of the patients were regularly evaluated during the postoperative follow-up. The overall 5-year survival rate was 55.83%, 58.33% in the sandwich group, and 53.33% in the conventional group (P = 0.50). The “sandwich” technique was superior to the conventional method in terms of postoperative complications: wound infection (P<0.01), prolonged wound healing time (P<0.01), titanium plate exposure (P<0.01) and reoperation (P<0.01); postoperative function: mouth opening degree (P<0.01), oral alimentation interval (P<0.01), decannulation (P<0.01), appearance, and postoperative quality of life (P<0.01). Rational application of the “sandwich” technique using the ALT chimeric musculocutaneous flap was advantageous because of the characteristics of various tissues. It is a practical, economical, and effective repair method.