Work

Impact of tumor localization and choice of microvascular flap on posterior airway changes following ablative surgery in primary oral squamous cell carcinoma: A monocentric cross-sectional study

Year: 2024

Type: article

Abstract: • Tumor location shows no significant impact on posterior-airway-space (PAS). • Flap type has a significant influence on PAS parameters. • Perforator flap transfer is worthwile in the follow-up in terms of function and performance. • Preoperative PAS values change significantly during treatment course. The aim of this study was to determine the influence of intraoral reconstructions following oral squamous cell carcinoma (OSCC) resection with a free microvascular flap on the posterior airway space (PAS) and to correlate these results with the potential risk of developing an obstructive sleep apnea syndrome (OSAS). Only primary OSCC cases of the tongue or floor of the mouth which were operated and reconstructed. The PAS displayed in computed tomography (CT) scans at three time points were analyzed: t 0 = preoperative, t 1 = first postoperative CT, and t 2 = most recent situation. The following three PAS parameters were calculated: minimum cross-sectional area (minCSA), mean cross-sectional area (meanCSA), and volume. MinCSA increased from t 0 to t 2 : t 0 = 86.9 cm 2 (0.0 – 251.8), t 1 = 106.6 cm 2 (1.0 – 483.4), and t 2 = 124.8 cm 2 (0.5 – 395.6). MeanCSA increased from t 0 to t 2 : t 0 = 225.1 cm 2 (79.0 – 500.2), t 1 = 247.8 cm 2 (102.8 – 674.3), and t 2 = 272.2 cm 2 (92.2 – 668.4). The volume increased from t 0 to t 2 : t 0 = 21.5 cm 3 (8.0 – 63.2), t 1 = 24.1 cm 3 (9.6 – 67.3), and t 2 = 26.9 cm 3 (6.2 – 67.4). Posterior airway space PAS values became higher than preoperatively. In particular, flap type had a significant influence on the three PAS parameters.

Source: Oral Oncology

DOI: 10.1016/j.oraloncology.2024.107080