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Pawar A, Rathod P, Warikoo V, Sharma M, Salunke A, Pandya S, Pandya S, Aaron J, Thottiyen S, Trivedi S, Kapur K, Bande V, Patel N, Yalla P, Joshi G. 'AJ's Orbicularis Oris Stitch: A Novel and Simple Technique of Reconstructing Central Arch Mandibular Defects in Resource-Constrained Set Up'. Indian J Otolaryngol Head Neck Surg 2023; 75:3703-3710. [PMID: 37974779 PMCID: PMC10645984 DOI: 10.1007/s12070-023-04044-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 06/26/2023] [Indexed: 11/19/2023] Open
Abstract
Lip and oral cavity SCC account for 2nd highest incidence of cancers and 3rd most common cause of mortality from cancer in India. Reconstruction of defects of central arch invading cancers results in poor cosmetic and functional outcomes if free flaps are not used. 30 patients with Oral SCC in the age group 20-75 years requiring central arch segmental mandibulectomy were included. Reconstruction was done with pedicled bipaddled PMMC flap with 'AJ's orbicularis oris stitch' using Fiber wire. Patients were divided into 4 groups according to extent of lip and skin loss post excision of primary tumour. Patients were evaluated with subjective scores for drooling, oral competence and cosmesis. There were 4, 12, 9 and 5 patients in Group A, B, C and D respectively. Mean subjective scores using our technique for drooling, oral competence and cosmesis were 3.75/4,3.75/4 and 3.5/4 for group A, 3.45/4, 3.36/4 and 3.09/4 for group B, 2.8/4, 2.6/4 and 2.3/4 for group C defects and 2.5/4, 3/4 and 2.5/4 for group D defects respectively. Over all scores for all patients were 3.2/4, 3.14/4 and 2.84/4 for drooling, oral competence and cosmesis. This simple, quick and inexpensive technique of reconstruction of central mandibular arch defects can drastically improve cosmetic and functional outcomes in a resource restrained set up. However, long term results and comparison studies are required for standardisation of the technique.
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Affiliation(s)
| | - Priyank Rathod
- Department of Surgical Oncology, GCRI, 1, Krushnapark Society, Karelibaig, Vadodara, Ahmedabad, Gujarat 390018 India
| | - Vikas Warikoo
- Department of Surgical Oncology, GCRI, 1, Krushnapark Society, Karelibaig, Vadodara, Ahmedabad, Gujarat 390018 India
| | - Mohit Sharma
- Department of Surgical Oncology, GCRI, 1, Krushnapark Society, Karelibaig, Vadodara, Ahmedabad, Gujarat 390018 India
| | | | - Shashank Pandya
- Department of Surgical Oncology, GCRI, 1, Krushnapark Society, Karelibaig, Vadodara, Ahmedabad, Gujarat 390018 India
| | - Shivam Pandya
- Department of Surgical Oncology, GCRI, 1, Krushnapark Society, Karelibaig, Vadodara, Ahmedabad, Gujarat 390018 India
| | - Jebin Aaron
- MCh Surgical Oncology, GCRI, Ahmedabad, India
| | | | | | | | - Vivek Bande
- MCh Surgical Oncology, GCRI, Ahmedabad, India
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