A role of silicon spacer for mandibular reconstruction in oral cavity squamous cell carcinoma- A prospective evaluation.

Abstract

Background: Although using a free flap with a microvascular technique is the gold standard of care, its use is limited in underdeveloped nations due to a lack of experience and resources. As a result, alloplastic materials and pedicled musculocutaneous flaps are commonly used in mandibular repair. Although numerous alloplastic materials have been employed with this flap, the majority of research has shown that they have a negative effect. The aim of the study was to see how effective silicon spacers are as a replacement for alloplastic materials in mandibular reconstruction.

Methods: A prospective study was conducted on patients who had mandibular reconstruction using soft-tissue repair with or without the use of a silicon spacer. The study comprised a total of 82 patients, 40 of whom had a silicon spacer and 42 of whom did not. The Chi-square test was utilized to assess the functional and cosmetic outcomes in both groups by using the EORTC head-and-neck questionnaire-35 analysis.

Results: The majority of the patients were in the T3 and T4a stages. The most common sub-site was buccal mucosa. The average silicon spacer retention time was 62 days, with a retention rate of 22.5%. Infection at the local portion, with or without orocutaneous fistula, was a common reason for silicon spacer removal. Only the speech parameter improved in the silicon spacer group, according to the EORTC head-and neck-questionnaire (P = 0.0290). In 16 individuals, radiation therapy was postponed, which was also significant (P = 0.0123).

Conclusion: In patients with oral cavity squamous cell carcinoma who underwent mandibular resection, using a silicon spacer in combination with soft-tissue restoration did not improve functional or cosmetic outcomes except for speech. For comprehensive mandibular reconstruction, only a myocutaneous flap is sufficient.