Local and Regional Flaps in Oral Cavity Cancer Reconstruction: A case-based approach

Oral cavity cancer presents unique challenges due to the region’s complex anatomy and vital functions. While microvascular reconstruction is the gold standard, it may not always be feasible due to limited resources, accessibility, advanced disease, or high post-operative care demands. This practical color atlas draws on the authors’ extensive experience to highlight local and regional flaps as effective alternatives in suitable cases. Featuring case examples, step-by-step guides, clear photographs, and access to operative videos, it provides a comprehensive yet accessible approach to reconstruction. This color atlas serves as a valuable resource for both junior and senior colleagues in the field of oral cancer surgery. It offers a collection of cases to inspire alternative approaches when standard solutions may not suffice. Surgical excellence lies in simplicity. While all authors are fully trained and practicing microvascular surgeons, the ability to achieve effective reconstruction with the appropriate technique is an art in itself.

Table of Contents:
1. Buccal mucosa Clinical Cases Discussion 2. Tongue Key Aspects of Defect Evaluation Treatment and Reconstructive Strategies Reconstructive Options for Tongue Cancer Clinical cases Discussion 3. Lip Lower lip Defects Clinical Cases Upper Lip Defects Clinical Cases Discussion 4. Upper alveolus, hard palate and lower alveolus Local/pedicled flaps Palatal defects Local / regional flaps Clinical Cases Discussion 5. Floor of mouth Reconstructive goals Clinical Cases Discussion 6. Reconstructive techniques Submental Flap Temporalis Flap Facial Artery Musculomucosal (FAMM) flap Deltopectoral Flap Palatal Island flap Pectoralis Major Flap The Nasolabial Flap Buccal Fat Pad Platysma Flap Infrahyoid Flap

About the Author :
Dr. Muhammad Faisal BDS, FCPS (OMFS), FDSRCS, FHNS Consultant Oral and Maxillofacial/Head and Neck and Reconstructive Surgeon. Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore Assistant Professor Oral and Maxillofacial Surgery, BAM&DC, Multan International Clinical Supervisor Head and Neck Oncology, EACMFS Co-director, Head and Neck Fellowship Program, SKMCH&RC Dr. Muhammad Faisal's surgical expertise, coupled with a strong passion for cancer research, has earned him recognition among his peers. Dr. Faisal’s research focuses on identifying factors that influence treatment outcomes for head and neck cancers, leading to valuable insights and collaborations in multicenter studies. His unwavering commitment to both clinical excellence and scientific advancement continues to drive progress in cancer care. Professor Abdul Ahmed BDS, MFDSRCS, MBChB, MRCS, DO-HNS, PGCert, FRCS(OMFS) Consultant Oral and Maxillofacial/Head & Neck/Reconstructive Surgeon.London Northwest University NHS trust Professor (Hons) Oral and Maxillofacial Surgery, BAM&DC, Multan Honorary Senior Clinical Lecturer Queen Mary University of London Honorary Clinical Lecturer University College London Professor Ahmed is a Consultant in Oral & Maxillofacial Surgery and Head & Neck Surgery at London Northwest Healthcare University NHS Trust and Chelsea and Westminster NHS Foundation Trust. With over a decade of experience as a consultant in OMFS and Head & Neck Surgery, he adopts an innovative approach to his practice, integrating cutting-edge technologies such as 3D planning, augmented reality, and robotic surgery. A prolific author, Mr. Ahmed has written multiple textbooks on Maxillofacial Surgery, Microvascular Surgery, and Head & Neck Cancer. His commitment to education extends to teaching engagements at various universities, where he leads courses in microvascular surgery, reconstructive surgery, and undergraduate/postgraduate training. Additionally, he is a national and international speaker, delivering lectures and conducting specialised courses worldwide. Mr. Ahmed also plays a key role in surgical education and governance. He serves as the Regional Specialty Advisor for the Royal College of Surgeons and as an Educational Supervisor for the London School of Surgery. Dr. Raza Hussain MBBS, BDS, FDSCRCS, FFDRCSI Consultant Oral and Maxillofacial/Head and Neck and Reconstructive Surgeon.Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore Director Head and Neck Fellowship Program, SKMCH&RC Vice President, Pakistan Head and Neck Society (PHNS) With over two decades of experience in managing complex head and neck cancers, Dr. Raza Hussain has skillfully navigated the challenges of treating cancer patients in an economically constrained environment, balancing limited resources with a high patient load. He has been involved in training postgrad trainees and fellows, lecturing and raising awareness for oral cancer in community, conducting hands on live surgery courses and publishing research in peer reviewed journals. Mr. Michael Gilhooly BDS, FDSRCS, MBChB, FRCS Consultant Oral and Maxillofacial/Head and Neck and Reconstructive Surgeon London Northwest University NHS trust With a career spanning over three decades, Mr, Michael Gilhooly has served as a consultant in Oral and Maxillofacial Surgery (OMFS) / Head and Neck Surgery. He is recognized as a trailblazer in modern microvascular surgery within the Northwest London region, having established his own surgical unit and contributing to the training of surgeons throughout his distinguished journey