Background:
The TMF was initially described in the late 1800s and has a broad application. In head and neck cancer, it can be used for reconstruction of intraoral defects in patients in whom free tissue transfer is contraindicated. This paper describes the use of TMF in a medically comorbid patient undergoing resection and reconstruction of a soft palate SCC.
Methods:
A 62 year old male with a medical background of heart failure with reduced ejection fraction, severe mitral regurgitation, coronary artery disease, pulmonary hypertension, carotid artery stenosis (up to 90%), and Chronic Obstructive Pulmonary Disease was diagnosed with a cT2N2b, p16 negative SCC of his right soft palate. He was treated with primary chemo-radiation therapy; however, he was found to have local and regional recurrence on his 3-month post treatment PET-CT scan. Salvage surgery in the form of wide local excision and selective neck dissection was undertaken. The soft palate defect was reconstructed with a right sided TMF.
Results:
The patient proceeded to surgery, which was performed without complication.
Conclusion:
Use of TMF in this complex case allowed for a reduced operative time with a satisfactory outcome. The TMF is a reconstructive option for medically comorbid patients who may not withstand lengthily general anaesthetic, as well as patients in whom free tissue transfer may be compromised due to previous radiotherapy treatment.