ICHNO-ECHNO 2022 - Abstract Book

S64

ICHNO-ECHNO 2022

Purpose or Objective Reconstructive surgery of external nasal defects after tumor resection is a serious challenge.

When planning an appropriate method, one should take into account many factors influencing its success, such as: division of the face into aesthetic subunits, the distribution of natural skin tension lines, and the vascularization of individual areas of the face and nose. Surgical techniques used in nasal reconstruction include many options for covering the postoperative defect. The most common restorative methods are locoregional techniques and microvascular free flaps. The aim of the study was to present selected advanced clinical cases in which complex reconstructions with the use of free flaps based on microvascular anastomosis were applied. Materials and Methods A total of 48 patients who were surgically treated at the Oncological and Reconstructive Surgery Clinic, National Cancer Institute in Gliwice, Poland in the years 2010-2020 were included in the study. The case histories of the patients were thoroughly analyzed. The functional and aesthetic outcome was assessed. Results 92 free microvascular free flaps were used for nasal reconstructions after extended resections. The following flaps were performed: radial forearm free flap (RFFF) in 24 patients, radial forearm free flap with radial bone in 14 patients, auricular free flap (AFF) in 16 patients, radial forearm free flap in combination with auricle free flap in 7 patients, double auricular free flap in 6 patients, radial forearm free flap in combination with double auricular free flap in 4 patients. Total necrosis of the free flap was noted in 4 cases, partial in 6 patients. Conclusion Composite full-thickness nasal defects which include adjacent facial units still remain a challenge for reconstructive surgeons. The choice of an adequate reconstruction technique has to be adjusted to each patient individually. AFF solely might not be sufficient for full coverage of a defect, and radial forearm free flap (RFFF) lacks the rigid component for nasal framework. A combination of two different flaps, such as chimeric flap of Aff+RFFF seems to be the best solution for the coverage of extended nasal defects. Very rarely combination of 2 free flaps require further corrections, making the reconstruction a one-stage procedure. The presented reconstructive strategies provide satisfactory aesthetic and functional effect in majority of patients. 1 NHS Greater Glasgow and Clyde Health Board, Maxillofacial Surgery, Glasgow, United Kingdom; 2 Ayrshire and Arran Health Board, Maxillofacial Surgery, Kilmarnock, United Kingdom; 3 University of Glasgow, Medical School, Glasgow, United Kingdom; 4 Private Consultant Software Engineer, Not Applicable, Glasgow, United Kingdom Purpose or Objective Patients undergoing sentinel node biopsy (SLNB) for early oral squamous cell carcinoma (OSCC) who harbour occult metastases (pN+ve) may be at greater risk of mortality, due to prolongation of overall treatment time, than those identified as pN+ve on elective neck dissection (ELND). A retrospective comparative survival analysis was therefore undertaken to test this hypothesis. Materials and Methods Patients were identified from the South Glasgow MDT database. Group 1 comprised 38 patients identified as pN+ve, or who were false negatives , on SLNB. Group 2 comprised 146 patients staged pN+ve on ELND. The groups were compared with the Kaplan Meier method and Cox Proportional Hazards Model. In addition, a match-pair analysis was performed. A unique and specifically designed algorithm was deployed to optimise the pairings PO-0109 Survival in node positive early oral SCC: sentinel node biopsy versus elective lymphadenectomy J. McMahon 1 , S. Hislop 2 , F. Zubair 3 , S. McNicol 4 , J. McCaul 1 , C. Wales 1 , M. Ansell 1