An Alternative Flap In a Patient of Cerebrovascular Accident with Oral Cancer

RGCIRC Team

Mouth Cancer

6 October, 2021

64 years old hypertensive, post CVA male patient (on blood thinners since Sept 2020) presented with nonhealing ulcer right lateral aspect of lower lip mucosa (pT4N2M0) which was diagnosed as well differentiated squamous cell carcinoma. He was planned for partial glossectomy, neck dissection and free flap reconstruction. The neurosurgeon had given clearance on high risk due to increased chances of intracranial bleed in view of the multiple microbleeds/ calcifications in B/L cerebral and cerebellar regions in the recent MRI, restricting the use of heparin in intra and post-operative period. In view of this, the surgical reconstruction was changed from radial artery forearm free flap to pedicled deltopectoral flap (for skin) and nasolabial (for mucosa). It was a good alternative with reasonably good final functional and cosmetic result.

Dr. Leena Dadhwal

Consultant – Surgical Oncology
RGCIRC, Niti Bagh, South Delhi