European Journal of Biomedical and Pharmaceutical Sciences

EARLY FUNCTIONAL AND POSTOPERATIVE OUTCOMES FOLLOWING LOCOREGIONAL RECONSTRUCTION AFTER HEAD AND NECK CANCER RESECTION: A RETROSPECTIVE TERTIARY CARE STUDY

Bhavya Wadhwani*, Suman Kharkwal, Pranav M. Singhal, Archana Yadav

ABSTRACT

Background: Head and neck cancer resection frequently results in complex functional and aesthetic defects requiring reconstruction. In resource-constrained settings, locoregional reconstructive options continue to play an important role in selected patients. Objective: To evaluate postoperative complications and early functional outcomes following reconstruction after head and neck cancer resection in a tertiary care centre. Materials and Methods: This retrospective observational study included 93 consecutive patients with histologically confirmed head and neck carcinoma who underwent surgical resection followed by reconstruction between January 2021 and December 2022 at a tertiary care centre in New Delhi, India. Demographic details, tumor characteristics, reconstructive procedures, postoperative complications graded according to the Clavien–Dindo classification, flap viability, and functional outcomes assessed using the Performance Status Scale for Head and Neck Cancer (PSS-HN) at 6 months were analyzed. Results: The mean age of the study population was 52.3 ± 11.9 years, and tobacco use was present in 84.9% of patients. Buccal mucosa (44.1%) and tongue (27.9%) were the commonest tumor subsites. Reconstruction methods included primary closure (30.1%), pectoralis major myocutaneous flap (28.0%), nasolabial flap (14.0%), others (15.1%) and split-thickness skin graft reconstruction (12.9%). Grade I complications occurred in 82 patients (88.1%), Grade II complications in 9 patients (9.7%), and Grade III complications in 2 patients (2.2%). No Grade IV or Grade V c omplications were observed. Total flap necrosis occurred in 2 patients, resulting in an overall flap survival rate of 96.2%. Mean duration of nasogastric tube feeding was 21 days. At 6 months, the majority of patients demonstrated satisfactory oral intake and understandable speech. Conclusion: Reconstruction following head and neck cancer resection using locoregional techniques remains a reliable option in appropriately selected patients. Acceptable complication rates, high flap survival, and satisfactory early functional outcomes were observed in this tertiary care cohort.

Keywords: Head and neck carcinoma; reconstruction; PMMC flap; nasolabial flap; postoperative complications; functional outcome.