Orofacial Soft Tissue Reconstruction with Locoregional Flaps in a Health Resource-Depleted Environment: Experiences from Nigeria

BACKGROUND: Reconstruction of orofacial soft tissue defects is often challenging due to functional and aesthetic demands. Despite advances in orofacial soft tissue defect reconstruction using free flaps, locoregional flaps still remain an important option, especially in health resource-depleted environments. This retrospective study highlights our experiences in oral and maxillofacial soft tissue reconstruction using locoregional flaps. METHODS: A twenty-three years retrospective analysis of all patients managed in our department was undertaken. Information was sourced from patients' case notes and operating theater records. Data was analyzed using SPSS ver. 16 (SPSS Inc.) and Microsoft Excel 2007 (Microsoft). RESULTS: A total of 77 patients underwent orofacial soft tissue defect reconstruction within the years reviewed. Males accounted for 55 (71.4%) cases and trauma was the main etiological factor in 45 (58.4%) of the patients treated. When sites of defect were considered, the lip, 27 (32.1%), was the most frequent site followed by the nose, 17 (20.2%). Forehead flap, 51 (59.3%), was the most commonly used flap. Complications noted were tumor recurrences at the recipient bed in 3 (3.9%) cases, tumor occurrence at the donor site in 1 (1.3%) case and postoperative infection in 11 (14.3%) cases. CONCLUSIONS: Locoregional flaps still have an important role in the rehabilitation of patients with orofacial soft tissue defects. They remain a vital tool in the armamentarium of the reconstructive surgeon, especially in health resource-depleted environments where advanced reconstructive techniques may not be feasible.

Quality of life following surgical treatment of oral cancers

INTRODUCTION: Quality of life (QoL) studies provide information about the impact of disease, the treatment of symptoms, and outcomes following treatment. The present study aims to evaluate the postoperative QoL of patients treated for oral cancer in a Nigerian government tertiary hospital. MATERIALS AND METHODS: A prospective study on consenting patients with oral cancer was undertaken at Aminu Kano Teaching Hospital, Kano, Nigeria. The subjects completed the University of Washington QoL (UW-QoL) questionnaire one day prior to surgery and postoperatively after 7 days, 1 month, 3 months, and 6 months. RESULTS: Sixty-eight patients with oral cancer were recruited. Of these, 38 were males, and 30 were females (male : female, 1.3 : 1). Twenty-four patients (12 males and 12 females) underwent surgery and completed postoperative QoL assessment using the UW-QoL questionnaire. Preoperative QoL mean score was 2.21, while postoperative mean scores after 1 week, 1 month, 3 months, and 6 months were 3.67, 3.46, 2.82, and 2.61, respectively. CONCLUSION: An improvement in QoL following surgical treatment for patients with oral cancer was observed. 'Appearance,' 'recreation,' and 'chewing' were identified as the most important determinants of postoperative QoL in patients with oral cancer in our study.