Functional tongue and floor of mouth reconstruction with a chimeric flap after total glossectomy

Three-Dimensional Analysis of Flap Volume Change in Total Tongue Reconstruction: Focus on Reinnervated Dynamic Tongue Reconstruction

“…In several cases of total glossectomy, the muscle component was placed to make an anteroposterior sling to mimic the hyoglossus muscle, thereby facilitating the backward movement of the tongue base during swallowing. 9,10 In our study, one end of the transferred muscle was anchored with the remnant soft tissue in the tongue base or in the hyoid bone, whereas the other end was sutured with soft tissue in the bottom of the flap and remaining soft tissue in the mouth floor. To prevent downward or posterior displacement of the larynx, a suspension suture was made between the vastus muscle and periosteal tissue in the posterior aspect of the chin.…”

“…On the basis of the calculated volume change in dynamic reconstruction (in Supplemental Table 3, Supplemental Digital Content 1, http://links.lww.com/SCS/F429), the fat portion was reduced to 77.04% and muscle portion was reduced to 69.06%, whereas in conventional reconstruction, the fat portion was reduced to 69.08%; however, the difference was not significant. Polyakov et al 10 reported a case of functional total tongue reconstruction through reinnervation of a chimeric flap, including the latissimus dorsi and serratus anterior muscles. Although they did not measure the flap volume accurately, the volume reduction of the reconstructed tongue was not significant during the follow-up period.…”

“…Dynamic reconstruction using functional muscle transfer to obtain functionally superior results in tongue reconstructions is emerging. [8][9][10] In dynamic reconstruction, reinnervation of the motor nerve is performed to utilize the muscle function. Unfortunately, only few studies have examined the change in flap volume in microvascular reconstruction with functional muscle transfer.…”

“…Recently, due to the large volume reduction and donor site morbidity, the frequency of using muscle free flaps is decreasing. Dynamic reconstruction using functional muscle transfer to obtain functionally superior results in tongue reconstructions is emerging 8–10 . In dynamic reconstruction, reinnervation of the motor nerve is performed to utilize the muscle function.…”