Objectives: To evaluate the feasibility, safety and 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 an angle fitting the excised
angle of the mouth. The flap included the bucirtator muscle and pad of fat. Prior to flap fixation the
mucosal lining was evaluated for being directly i-ppipmated or a mucosal flap was fashioned; for
extensive excisions and lingual flap of the ipsilateral;tongue 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 ipsilateral lingual 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 |
