Quality of Life Assessment and Comparative Analysis of Anterolateral Thigh Flap and Pectoralis Major Myo-cutaneous Flap for Reconstruction of Post Excision Defects of Oral Squamous Cell Carcinoma

Arjun Mahajan; Janani Anand Kumar; Akhilesh Kumar Singh; Naresh Kumar Sharma; Farhan Durrani; Neeraj Kant Agrawal; Neville Jf

doi:10.1007/s12070-024-04697-6

Quality of Life Assessment and Comparative Analysis of Anterolateral Thigh Flap and Pectoralis Major Myo-cutaneous Flap for Reconstruction of Post Excision Defects of Oral Squamous Cell Carcinoma

Indian J Otolaryngol Head Neck Surg. 2024 Aug;76(4):3390-3395. doi: 10.1007/s12070-024-04697-6. Epub 2024 Apr 12.

Authors

Arjun Mahajan¹, Janani Anand Kumar², Akhilesh Kumar Singh³, Naresh Kumar Sharma³, Farhan Durrani⁴, Neeraj Kant Agrawal⁵, Neville Jf⁶

Affiliations

¹ Fellow Head and Neck Oncology, Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh India.
² FHNO Oral Oncology Fellow, Aster Malabar Institute of Medical Sciences, Kozhikode, Kerala India.
³ Unit of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh India.
⁴ Unit of Periodontology, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh India.
⁵ Department of Plastic surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh India.
⁶ Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh India.

PMID: 39130307
PMCID: PMC11306680 (available on 2025-08-01)
DOI: 10.1007/s12070-024-04697-6

Abstract

Present study is a comparative evaluation of the financial impact on choice of flap, clinical results as well as post resection quality of life assessment of cancer patients reconstructed with anterolateral thigh(ALT) flap and pectoralis major myo-cutaneous(PMMC) flap. Ethical clearance was obtained from institutional ethical committee. In this non-randomised, prospective study design among 49 oral squamous cell carcinoma cases, 39 cases were reconstructed using PMMC flap and 10 using ALT flap from year 2020 to 2022. These 2 flaps were compared in terms of parameters like time utilised for reconstruction, hospital stay, overall survival and Washington University Quality of Life index(UW-QOL) for head and neck cancer. Patients were followed regularly for post-operative complications. The University of Washington Quality of Life score (UW-QOL) questionnaire, version 4, was completed at six months post-operatively. Obtained data was statistically analysed using IBM^® SPSS^Ⓡ. Washington University Quality of Life index scores and esthetics are better with Antero-lateral thigh flap, with less overall post-operative complications. On the other hand Pectoralis myocutaneous flap has less surgical time and more salvage potential. Despite of Antero-lateral thigh flap having Good Washington University Quality of Life index scores, lesser post-operative complications and better esthetics; scale of developing nations is still tipping towards economical, less time consuming and less technique sensitive Pectoralis major myocutaneous flap.

Keywords: Anterolateral thigh flap; Comparative ananlysis; Oral squamous cell carcinoma; Pectoralis major myocutaneous flap; Reconstruction.

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