Mutilating surgery with free flap in oral and oropharyngeal cancer: A report of case series

Abstract

Introduction: Globally, oral cancer is the eighth most common malignancy with over 300,000 people are diagnosed in each year. It is also the third most common cancer in South East Asia. The tongue is the most common intraoral site for cancer. The aim of this study is to highlight the relevance of mutilating surgery of head and neck cancer in the current minimally invasive and robotic surgery era.Case description: We present four case series of tongue carcinoma who underwent combined mandibulectomy, neck dissection (COMMANDO), resection of tumours and reconstruction with anterolateral thigh flaps. All cases showed remarkable outcome in which the flap was viable and healthy, with good tongue mobility postoperatively. All patients were discharged from ward two weeks after operation with tracheostomy tube decannulated.Conclusion: COMMANDO operation with anterolateral thigh flap reconstruction is relevant in the current era, especially for the late and advanced stages of oropharyngeal carcinoma. Therefore, multidisciplinary trained surgeons are required to perform these cases, i.e. qualified head and neck surgeon with reconstructive teams.Â