Objectives: To evaluate the feasibility, safety, functional and aesthetic outcome of
rhomboid cheek flap for wound closure after excision of mouth angle carcinoma.
Patients & Methods: The study included 23 patients; 13 had basal cell carcinoma and
10 patients had squameous cell carcinoma with a mean diameter of lesions of 2.6±1
(1.2-4.5) cm in its greatest diameter. Nodal involvement was detected in 10
specimens. Surgical resection was performed with safety margin; a rhomboid flap was
fashioned and adjusted to construct a new angle of the mouth. Prior to flap fixation
the mucosal lining was evaluated for being directly approximated or a mucosal flap
was fashioned; for extensive excisions a tongue flap was fashioned and used for
mucosal defect closure. Wound edges were approximated with tension free suturing
and wound was drained. After complete wound healing, all patients underwent
functional and aesthetic evaluation.
Results: All patients had primary surgical excision and immediate repair
without intraoperative problems or complication with a mean operative time was
154.7±19.7 min and mean operative blood loss was 311.5±51.8 cc. Closure of the
resultant cheek mucosal defect was feasible by direct closure in 14 cases, 5 cases
required mucosal rotational flap and direct closure .of donor area, while 4 cases
required tongue flap. Six patients had postoperative surgery-related morbidities for a
rate of 26.1%. Mean postoperative satisfaction score was 10.9±2.2; range: 6-14; 6
patients had score of <10, 10 patients had score ranged between 10 and 12 and 7
patients had score of more than 12.
Conclusion: lpsilateral rhomboid shaped cheek flap is appropriate surgical modality
for reconstruction of the angle of the mouth after resection for carcinoma and provide
acceptable functional and aesthetic outcome |
