MICROSURGICAL RECONSTRUCTION OF THE ORAL CAVITY IN PATIENTS WITH ONCOLOGICAL DISEASES

Abstract

Objective: Improving the functional results of microsurgical reconstruction of the tongue after radical oncological
operations. Material and methods: In the Department of Neck Head Tumors and Reconstructive Surgery, Bukhara
Regional Branch of the Republican Specialized Scientific and Practical Medical Center for Oncology and Radiology, in the
period 2017-2019, surgical treatment was performed for ten patients with tongue cancer with plastic skin and fascial
radial graft from the forearm using microsurgical technique. In nine patients with a diagnosis of cancer of the lateral
surface of the tongue, T1-2N0-1M0 stages were detected and in one patient T3N1M0 stages were detected. All patients
underwent surgical treatment in the amount of: hemiglosectomy, cervical lymphadenectomy and microsurgical plastic
surgery of the tongue with reinnervated, skin-fascial radial graft from the forearm. Microsurgical plastic surgery was
performed simultaneously for one patient with a diagnosis of T1N0M0, and in other cases, at the first stage, 2-4 courses
of polychemotherapy were performed according to the scheme: Cisplatin 75 mg / m2, fluorouracil 750 mg / m2 or
chemoradiotherapy and after partial regression of the tumor in the second stage, surgical treatment and restoration
of the tongue. Results: The observation period ranged from 2 to 22 months. The overall survival of the flap was 80%.
In two cases in the postoperative period, flap necrosis was detected. In one patient, after 6 days of surgery, arterial
thrombosis of a microvascular anastomosis was found, with which the flap was removed, in the second after 10 days
due to suppuration after the surgical wound, the flap was removed. The average healing time for the region of the
donor forearm was 4 weeks. Conclusion: Our first experience shows that microsurgical reconstruction of the tongue
is a good reconstructive option for patients and improves the functional qualities of patients after surgery in terms of
speech, chewing and swallowing.