Nasogenian flap for reconstruction of oral cavity lesions

A case report

Abstract

Introduction: Maxillectomy is the recommended surgical intervention for the excision of facial neoplasms. This technique includes the resection of the jaws and adjacent anatomical structures, and entails different degrees of functional alteration. The reconstruction of mid-facial defects represents a great challenge, different techniques are used from the use of obturator prostheses, local flaps, to free flaps, with the aim of greater recovery of sophisticated functions such as speech, swallowing and ventilation in via upper area.

Case report: An 89-year-old male patient with a 4-month evolution of a tumor mass with progressive and constant growth in the middle of the upper palate and extending taking the right upper jaw. Physical examination revealed the cavity with poor dental care and a tumor mass of more than 15 cm in diameter that deformed the oral cavity.

Evolution: A lumpectomy and lymph node dissection were performed with preservation of the spinal, hypoglossal, lingual, sternocleidomastoid muscle, internal jugular vein, vein and facial artery. A neo-palatal reconstruction with a nasolabial flap was performed. The definitive pathology received in later days reported a poorly differentiated squamous cell carcinoma of epithelial lineage with a positive surgical border for the tumor. Within the postoperative period, the patient presented pneumonia associated with health care, accompanied by neurological deficit, the condition regressed to sepsis of pulmonary origin and died 21 days after surgery.

Conclusions: The accelerated growth of a maxillary mass in this patient was associated with the presence of a poorly differentiated squamous cell carcinoma.