Comparative evaluation of functional and esthetic outcomes in reconstruction of Commissure of Mouth with radial forearm free flap with and without Palmaris Longus Tendon in patients being operated for squamous cell carcinoma of Buccal Mucosa and lip

Introduction-: Our experience demonstrates the effectiveness of radial forearm flap (RFF) in lip deformity and buccal mucosa restorations, both with and without Palmaris Longus Tendon. The best therapy after large oncologic resections is with microvascular free flaps. The tissue produced by the Radial Forearm Free Flap is thin, malleable, and well-vascularized. It guarantees less morbidity at the donor site because it is harvested pedicled on the radial artery. Successful vascularization is facilitated by microvascular anastomosis. With a high success rate, RFFF provides good functional and cosmetic results for a range of intraoral reconstructions.

Need of the study This study will help evaluate the functional and aesthetic results of reconstructing the lip and buccal mucosa in cases with squamous cell carcinoma. Long-term preservation of the vertical lip height and lip supports is carried out by the Palmaris Longus Tendon, which functions as a sling over which the flap is elevated.

Aim: The study is design to compare & evaluate functional & estheticoutcomes in reconstruction of Commissure of Mouth with radial forearm free flap with & without Palmaris Longus Tendon in patients being operated for squamous cell carcinoma of Buccal Mucosa and lip.

Materials and Method**:**  Prospective Observational study. The clinical study will be performed at the Department of Oral and Maxillofacial Surgery, Siddharth Gupta Memorial Cancer Hospital, Sawangi, Wardha, Maharashtra. After taking approval from the IEC, DMIHER (DU) and explaining detailed treatment protocol to the patients. Procedure will be performed in patients which are histopathological proven. Detailed Case History,Clinical Examination,Past medical, dental history, general personal information, and then biopsy will be performed. In patient with biopsy proven of Squamous Cell Carcinoma, further be subjected to Radiographic Examination (CT SCAN) for knowing the extent of lesion, metastasis of lymph node. Patients with Biopsy proven  and those who are meeting the inclusion criteria will be included in the study after obtaining detailed informed consent.

2 group in which 8 patients with Radial forearm free flap with Palmaris Longus Tendon & 8 without Palmaris Longus Tendon in which functional outcomes like Drooling, Swallowing, Speech & Esthetics outcomes Smile, Lip Competence & Commissural ends will be assessed.