Shailendra B Singh, Archana Thakur, Rahul Kaushik, Deepanjali Kalra and Manisha Singh
Presented here is a case of Recurrence in Oral Cancer. Three years back, the patient had under gone Glossectomy with reconstruction using Pectoralis Major Myocutaneous Flap. Patient developed a recurrence on right buccal mucosa and alveolus. It was fungated with pungent smell and was extruding through the right cheek. It was neglected by the patient hence the delay. The malignancy appeared inoperable but patient’s relative insisted, hence we decided to operate upon the patient. The plan was bipedal Pectoralis Major Myocutaneous flap (PMMC) for coverage of resultant defect following Oncological excision. The excised specimen included skin of right cheek up to Zygomatic arch, to upper third of neck with Buccal mucosa, Retromolar trigone, lower partial upper maxilla, pterygoids and both the upper and lower lip. So it was half of the right face-up to the upper third of neck including the lower lip. It was a Hemi facial defect Since adequate facilities for microsurgery were not available. Two pedicle flaps were needed, as left PMMC was used in first surgery, so we decided to use fore head flap for inner lining, floor of mouth and it was folded upon itself to form the lower Lip. Right spiral PMMC flap of the size 18 X 16 cms with nipple was used as the outer cover with skin grafts at both the donor sites. Patient tolerated surgery and post operative period was uneventful. The reconsruction was a successful endeavor.