Radial arm free flap question?

Mike_Thompson

Hi All;

I am a recent new member to this forum and I have read many of the posts and have found them to be really helpful.

For context, I am 48 years old, non smoker, HPV negative and a decent competitive runner. I am also a recent survivor of SCC. A year ago I had a biopsy done and was found to have a T1 N0 M0 that was on the back right side of my tongue.  In Decmeber 2014 I had surgery which included a mandibulotomy, removal of a few lymph nodes and use of a forearem flap for replacement of the area surgically removed. Radiation was not recommended or required post op as my margins and lymph nodes were deemed to be clear.

Like many of you have expressed in your posts I too suffer from anxiety and fear about what happened and what "could" happen again.  The lead up to my follow-up appts is always very very stressful and almost physically debilitating.  This, in itself, could take up hours discussing.  So in the interest of brevity, I will keep that for another time

My concern is specifically regarding the transplanted piece of my forearm. I have noticed that it rubs constantly against one of my molars. As a result, a white patch and lines had appeared in early July 2015 which basically resembled a topographic map of the tooth. I tried a mouth guard and the patch disappeared after a few days. I stopped using it and the patch reappeared. I saw my ENT in August and he indicated that it was purely frictional and was common for free flaps to experience this. A biopsy was not recommended other than to put my mind at ease. I declined the offer. 

Anyway, I went and saw a dentist about removing the tooth and / or have it filed down. Both options were declined as it is a healthy tooth and that was seen as too drastic a solution. As of today the area has not changed much other than to have gotten smaller and more defined. That being that the spot and lines fit perfectly with the ridges and bumps of my molar.

My question is simply this. Is there anyone out there that has had a similar experience and if so, what did you see and how was it managed by your ENT and / or dentist? 

Thanks;

Mike;

wmc

Welcome to the H&N Group Mike

Welcome to the group, but sorry you needed to be here. I can't help with your problem, but I believe thers is some that might have some answers or at least sugestions. My surgery was in the throat and no flap was needed. All I can say is glad you came through it good and most everyone does have some anxity before check ups. Some even named it scanaxity. Are you aware of it hitting during the day or is it more when you sleep? If more at night I see why you used the mouth guard. Wish you the best with this as it would bother me as well.

Bill

Mike_Thompson

wmc said:

Welcome to the H&N Group Mike

Welcome to the group, but sorry you needed to be here. I can't help with your problem, but I believe thers is some that might have some answers or at least sugestions. My surgery was in the throat and no flap was needed. All I can say is glad you came through it good and most everyone does have some anxity before check ups. Some even named it scanaxity. Are you aware of it hitting during the day or is it more when you sleep? If more at night I see why you used the mouth guard. Wish you the best with this as it would bother me as well.

Bill

Thanks Bill. I feel fortunate

Thanks Bill. I feel fortunate to have found that there are others out there that have had or are unfortunately currently having similar experiences to mine. To answer your question, I am more aware of it during the day as it, sadly, is what my mind drifts to and that is accompanied, of course, with fear. Anyway, hopefully someone in the group has heard of this or has had a similar experience and can offer some sage words.

 

Mike;

phrannie51

Hi Mike....and welcome....

to the forum.....the club nobody wants to join.  I never had any surgery, so I can't address a flap....I can address the anxiety of having "something" that bears watching.  I've had many things that I've watched and worried about through the last 3 years, none of which came to anything. 

Since you didn't have radiation then the only reason to keep this tooth is because it's "healthy"....something dentists cherish.  But, it's causing you non-ending angst and worry....so why keep it?  If the dentist and ENT can give you good enough reasons for hanging onto this tooth, and convince you that the indentation/irritation to the flap is inconsequential....fine.  Otherwise, I'd ask him to pull it and put your mind at ease.  There's enough to worry about after having this disease.

p 

lornal

irritation

I had the flap, but it was reconstruction for my esophagus.  THat was last year - and I had a total laryngectomy.

But, in 2007, I had stage 4 tonsil cancer - surgery, chemo, and radiatio.  It was the right tonsil.  The doc dug deep when took the tonsil out, but still didn't get it all.  But, I have since thad white patches on that side of my mouth by my wisdom tooth (lower).  Always white, and I often get cancor sorest there.  I see the ENT twice a year, and the dentist.  My are keeping watch.  And, I think the doc might take a biopsy next year - but, he isn't worried, so I not (as) worried as I would be otherwise.

lorna

2007 & 2014

MGC

Any other boards with this type of content does anybody know about?

So little information out there on this. I had it done in 2019. Mega side effects but I am still here.

Thanks

Mark