Oral cancer surgery turns less complex now

KOCHI: Reconstruction using the inner part of the cheek is emerging as a new technique for treating small to medium oral cancer. Oncologists say this marks a deviation from the present technique of treating defects of the tongue and the floor of the mouth by reconstruction using microvascular surgery. Tissue from an away part in the body like the hand is taken while doing microvascular surgery.

“This complex microvascular procedure impacts the defect to the donor site and usually it requires a skin graft taken from another part of the body to cover the donor area defect. In such cases, ICU stay up to five days is needed and there is the possibility of flap failure and may need secondary procedures,” said Dr. Shawn T. Joseph, head and neck surgical oncologist at VPS Lakeshore Hospital.
Usually microvascular surgeries take four to six hours. Hospitals with limited facilities would find it difficult to undertake such procedures.

“In the new method, tissue from the inner part of the cheek is dissected along with supplying blood vessels from the neck and taken to the neck from where it is moved to the oral cavity or throat where reconstruction is required. This process takes only up to one and a half hours,” Dr. Shawn T. Joseph said. “The impact of the new procedure is that it avoids all morbidity associated with microvascular surgery. It is less expensive and ICU stay is reduced to one day. It can also be undertaken at hospitals with limited facilities. As the tissue is taken from the oral cavity itself, the appearance of the reconstructed tongue is very similar to the normal tongue. “ The article on this count by Dr Shawn T. Joseph, Dr. Mihir Mohan, Dr. Naveen B.S., and Dr. Jose Tharayil has been published in PubMed-indexed journals like the International Journal of Oral and Maxillofacial Surgery and Craniomaxillofacial Trauma and Reconstruction.