Cancer patients with large defects. Reconstructional options: a case study

Area of Science:

• Oncology
• Head and Neck Surgery
• Reconstructive Surgery

Background:

• Squamous cell carcinoma (SCC) of the external ear can present aggressive recurrence patterns.
• Previous treatment involved surgical excision, neck dissection, pectoralis major flap reconstruction, and radiotherapy.
• Recurrence necessitates complex management strategies to ensure oncological control and functional restoration.

Observation:

• A 75-year-old male presented with extensive recurrence of SCC involving temporal bone, mandible, parotid gland, and cranial nerves.
• The recurrence extended to critical structures including the facial nerve and internal jugular vein.
• Previous treatments included surgery, radiotherapy, and pectoralis major flap reconstruction.

Findings:

• Complete surgical resection of the recurrent tumor was achieved with wide, healthy margins.
• Functional and aesthetic reconstruction utilized a combination of a metal-fixed prosthesis for the mandible and a myocutaneous trapezius flap.
• This approach addressed extensive defects involving bone, soft tissue, and neural structures.

Implications:

• This case highlights the feasibility of complex reconstructions for advanced head and neck SCC recurrence.
• Modern reconstructive options, including prostheses and flaps, can significantly improve quality of life for cancer patients.
• Effective management of recurrent SCC requires a multidisciplinary approach integrating surgical expertise and advanced reconstructive techniques.