Intraoral anastomosis technique as part of the reconstruction strategy following resection of intermediate and low-grade head and neck cancer

Introduction: The gold standard for curative treatment of facial, oral, nasal, paranasal and pharyngeal cancers is excision and reconstruction surgery. Patients are increasingly demanding carcinologically effective and minimally invasive surgery with near ad integrum functional and aesthetic reconstruction. In malignant tumors with no indication for lymph node dissection, when the defect size dictates free flap reconstruction, the intrabuccal anastomosis technique comes closest to meeting these requirements. Material and methods: In this single-center retrospective observational study, we reported a series of 5 patients with intermediate or low-grade head and neck cancer treated by surgery between 2022 and 2023 at the Cervico-facial Surgery Department of the Gustave Roussy Cancer Center. We collected clinical, therapeutic, histologic, and carcinologic data. Results: All patients underwent tumor resection with fascio-cutaneous free flap reconstruction and dental rehabilitation in accordance with best practice recommendations. None of the patients had an indication for lymph node dissection. The histologic subtypes were glandular, epithelial, and cartilaginous-related. All anastomoses were performed on the facial vessels using an intraoral anastomosis technique. Conclusion: Free flap with intraoral anastomosis technique may be the first intention reconstruction strategy for large defects following resection of intermediate and low-grade malignant tumors of the face and oral, oropharyngeal, nasal or paranasal cavities.