Abstract

Background: Extensive surgical resection of oral cavity cancer often results in large soft tissue defects, significantly impairing speech, swallowing, and aesthetics. When free flap reconstruction is not feasible, pedicled regional flaps offer an effective alternative, allowing functional restoration with shorter operative times and reduced costs. This study aimed to evaluate the outcomes of using pedicled regional flaps for oral cavity reconstruction after oncologic resection.

Methods: A prospective descriptive interventional study was conducted on 30 patients with oral cavity cancer at the Center of Maxillofacial Surgery – Hue Central Hospital from June 2023 to June 2025. Patients with moderate to large soft tissue defects following tumor ablation underwent immediate reconstruction using pedicled regional flaps. Five types of flaps were utilized: pectoralis major myocutaneous flap (12 cases), supraclavicular artery island flap (5 cases), submental island pedicled flap (4 cases), facial artery musculomucosal flap (2 cases), and temporalis myofascial flap (5 cases). Patients were monitored for wound healing, early complications, and postoperative functional recovery.

Results: All 30 patients underwent successful reconstruction using appropriate pedicled flaps, achieving a 100% flap survival rate with no cases of total necrosis. Early complications were noted in 5 cases (16.7%), mostly minor and managed conservatively. No major complications or surgery-related mortality occurred. Functionally, most patients showed significant improvement in mastication and speech. Notably, thin mucosal flaps such as the facial artery musculomucosal flap provided excellent outcomes, with 91.7% resuming normal oral intake and 83.4% regaining intelligible speech after recovery.

Conclusions: Pedicled regional flaps remain a safe and effective option for oral cavity reconstruction following cancer surgery, especially when free flap transfer is contraindicated. This study demonstrates that flaps such as the pectoralis major, supraclavicular, submental, facial mucosal, and temporalis muscle flaps offer reliable wound healing and functional restoration. Proper flap selection based on defect size and location optimizes reconstructive outcomes.