Voie d’abord transorale et cervicale sans mandibulotomie dans les cancers de l’oropharynx avec réparation par lambeau libre fasciocutané antébrachial

Abstract

Objective

To evaluate the role of a combined transoral and cervical approach without mandibulotomy for surgery of oropharyngeal cancer with fasciocutaneous radial forearm free flap reconstruction.

Material and methods

All patients who underwent this type of surgery between 2003 and 2007 were included in this retrospective study. We analyzed postoperative outcomes, surgical margins (histological study) and the oncological and functional results.

Results

A total of 24 patients were included in this study. There was no free flap failure. Surgical margins were negative for 23 of the 24 patients. At 3 years, overall, cause-specific, and disease-free survival rates were 73, 76 and 68%, respectively. A good functional result (normal or slightly impaired function) was obtained for oral diet, speech, mouth opening and esthetic outcome in 78, 82, 92 and 86% of the patients, respectively.

Conclusion

This double surgical approach without mandibulotomy in selective cases can replace the transmandibular approach in locally advanced oropharyngeal cancer surgery.