Head and Neck Cancer

Head and neck cancers are most common cancer in India due to various form of tobacco consumption. Oral cancers are treated with multimodality approach including surgery, radiation and chemotherapy. Composite resection of tumor is the crucial part of treatment. Patient develops speech and swallowing difficulty after major resections. Organ conservation surgery, radiation strategies, reconstruction with locoregional and free flaps are used in an attempt to maintain or reestablish functional speech and swallowing in head and neck cancer patient.

This 65 years old male patient presented with growth at right lower jaw and diagnosed as carcinoma lower alveolus. Composite resection with neck dissection (COMMANDO OPERATION) with pectoralis major myocutaneous (PMMC) flap reconstruction was done. This is one of the most common oncosurgery performed at any cancer center due to high prevalence of oral cancer in India.

This 42 years old male patient presented with carcinoma of left cheek. Treated with composite resection with neck dissection and bipaddle PMMC flap reconstruction. Patient recovered well with good functional and cosmetic outcome.

This 29-year-old young patient presented with locally advanced carcinoma of right cheek. He received 3 cycles of neoadjuvantchemotherapy. Composite resection (WLE with right hemimandibulctomy with subtotal maxillectomy ) with neck dissection and bipaddle PMMC flap reconstruction was done. Patient recovered well with satisfactory cosmetic and functional outcome.

This 70 years old male patient presented with carcinoma right cheek with no significant neck node. Composite resection with modified neck dissection was done and reconstruction was done with bipaddle submental flap. Patient recovered well with good functional outcome. Submental flap is a very good reconstruction option for oral cancers in clinically N0 neck.

Another patient of carcinoma right cheek who underwent commando surgery and submental flap reconstruction with very good cosmetic and functional outcome.

Tongue cancer is a frequent site for oral carcinoma. Surgery with or without adjuvant therapy remains treatment of choice. Significant morbidity related to speech and swallowing may occur after surgical resection of tongue cancer. Infrahyoid flap is a reliable method of tongue reconstruction and has a good functional outcome in term of speech and swallowing.

This 42 years old female patient presented with carcinoma left lateral border of tongue. She underwent left hemi glossectomy and infrahyoid flap reconstruction. Patient has almost normal speech and swallowing function.

Another 30 years old female patient of carcinoma right lateral border in which compartment resection and infrahyoid flap reconstruction was done. This flap is a very good alternative reconstruction option of free flap for tongue reconstruction with good functional outcome. It is reliable, easy to harvest during neck dissection, oncologically safe, itcarries a negligible donor site morbidity.

Another male patient of tongue carcinoma in which right hemi glossectomy and infrahyoid flap reconstruction was done. This flap is based on superior thyroid vessels.

This 62 years old male patient presented with advanced stage togue carcinoma. He received 3 cycles of neoadjuvant chemotherapy. Total glossectomy with marginal mandibulectomy with radical neck dissection with PMMC flap reconstruction was done. Patient recovered welland received adjuvant chemoradiation.

Reconstruction of lower lip defect is a challenge for surgeons. This 65 years old male patient presented with carcinoma of lip involving whole lower lip. Wide local excision of lower lip was done and reconstruction was done with GATE flap. Patient has very good cosmetic result and oral commissure competency.

60 years old male patient was diagnosed as carcinoma floor of mouth. Composite resection of FOM with marginal mandibulectomy with B/L SOHD was done. Reconstruction was done with one stage Nasolabial flap. Patient has very good cosmetic and functional outcome.

This 25 years old young patient was diagnosed with carcinoma left buccal mucosa. Wide local excision with neck dissection was done. Reconstruction was done with Nasomentolabial flap.

30 years old young patient diagnosed as carcinoma right maxilla. Right subtotal maxillectomy with modified neck dissection was done. Post-surgery interim obturator was used. It promotes surgical healing and serves as a temporary prosthesis to rehabilitate a patient with intra-oral surgical defect. Patient received adjuvant radiation therapy. After treatment completion, patient was rehabilitated with permanent maxillary obturator with dental prosthesis.

81-year-old female diagnosed as BCC (basal cell carcinoma) of left lower eyelid. Wide local excision of lower eyelid tumor was done. Reconstruction was done with Fricke flap and buccal mucosa graft. Patient has excellent cosmetic and functional outcome.

58 years old female presented with BCC nose. Wide local excision was done. Reconstruction was done with Bilobed flap with excellent cosmetic result.

32 years old male patient diagnosed as carcinoma upper eyelid. Wide local excision of upper eyelid tumor was done. Reconstruction was done with paramedian forehead flap and buccal mucosa graft.

Patient presented with BCC of left cheek. Wide local excision was done. Reconstruction was done with Mustardee flap.

Patient diagnosed as BCC of right cheek. Wide local excision and reconstruction with Limberg flap was done.

This young patient presented with recurrent scalp swelling. Wide local excision of tumor was done. Reconstruction was done with scalp rotation flap and skin grafting. Final histopathology was Dermatofibrosarcoma Protuberance.

This 83years old female patient was diagnosed as malignant melanoma of right cheek. Wide local excision was done. Reconstruction was done with forehead flap.

58 years old male patient presented with recurrent BCC of right post-auricular region. Wide local excision with cervical advancement flap reconstruction was done.

78 years old male patient presented with squamous cell carcinoma of right ear. Wide local excision with primary closure was done.

This 63 years old patient diagnosed as Trichofolliculoma (adnexal skin tumor). Wide local excision with paramedian forehead flap reconstruction was done.

This 28 years old male patient was diagnosed with thyroid cancer. Total thyroidectomy with central compartment clearance and right lateral compartment dissection was done. Final histopathology was classical variant papillary carcinoma. Patient is fine after surgery.

Parotid gland is most common site for salivary gland tumors and most of them are benign and only 20% are malignant. Preservation of all branches of facial nerve is very crucial during parotidectomy.

This 48 years old male patient presented with locally advanced left parotid tumor. Left total parotidectomy with facial nerve preservation with PMMC flap reconstruction was done. Final histopathology was high grade mucoepidermoid carcinoma.

38 years old female patient presented with large right parotid tumor. Right total parotidectomy with facial nerve preservation was done. Final histopathology was pleomorphic adenoma.

A case of recurrent mucoepidermoid carcinoma right parotid gland. Right radical parotidectomy with resection of facial nerve was done because of involvement of nerve by tumor.