手术构成了大多数局部或晚期口腔鳞状细胞癌的治疗支柱。不幸的是，感染性并发症（包括口腔皮肤瘘管）在如此广泛的手术后很常见，并且可能影响一半以上的患者。这些并发症可能导致辅助治疗延迟、住院时间延长、重建失败和生活质量下降。与感染并发症相关的频率和发病率导致人们寻找诱发危险因素；并且，已经确定了一些因素，包括患者（例如糖尿病）和手术（例如手术时间）因素。然而，这些发现的重复结果不一致，并且危险因素修改对感染并发症发生率的影响有限。鉴于可能的污染物——口腔微生物组——是一个经过充分研究的微生物库，这一点是惊人的。由于许多口腔癌手术涉及口腔粘膜的侵犯以及口腔微生物组溢出到正常无菌区域（例如颈部），因此口腔微生物组组成和功能的差异可能是感染并发症差异的基础。这一观点的目标是强调 1) 这种知识差距和 2) 该领域的研究机会。这一思路的含义是，在接受口腔癌手术的患者中识别口腔微生物失调可能会导致有针对性的术前治疗干预、减少感染并发症并改善患者预后。版权所有 © 2024 Elsevier Ltd. 所有权利预订的。

Surgery forms the backbone of treatment for most locoregional or advanced oral cavity squamous cell carcinoma. Unfortunately, infectious complications (including orocutaneous fistulas) are common following such extensive surgery and can afflict over half of patients. These complications can lead to delays in adjuvant treatment, prolonged hospitalization, reconstructive failure, and decreased quality of life. The frequency and morbidity associated with infectious complications has led to the search for pre-disposing risk factors; and, several have been identified, including both patient (e.g. diabetes) and surgical (e.g. operative time) factors. However, these findings are inconsistently reproduced, and risk factor modification has had a limited impact on rates of infectious complications. This is striking given that the likely contaminant-the oral microbiome-is a well-studied microbial reservoir. Because many oral cavity cancer surgeries involve violation of oral mucosa and the spillage of the oral microbiome into normally sterile areas (e.g. the neck), variance in oral microbiome composition and function could underly differences in infectious complications. The goal of this perspective is to highlight 1) this knowledge gap and 2) opportunities for studies in this domain. The implication of this line of thought is that the identification of oral microbial dysbiosis in patients undergoing surgery for oral cavity cancer could lead to targeted pre-operative therapeutic interventions, decreased infectious complications, and improved patient outcomes.Copyright © 2024 Elsevier Ltd. All rights reserved.