Modified pectoralis major myocutaneous flap for the total glossectomy defects: Effect on quality of life

Gangiti, Kranthi Kumar; Gondi, Jonathan T.; Nemade, Hemantkumar; Sampathirao, L.M. Chandra Sekhara Rao; Raju, K. V. V. N.; Rao, T. Subramanyeshwar

doi:10.1002/jso.24260

Cited by 12 publications

(5 citation statements)

References 15 publications

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“…This allowed the use of thin free flaps (eight suprafascial‐ALT and six RFF; 82% of cases), which have good pliability and versatility; they restore almost half of the tongue volume loss while preserving its complex mobility . In case of contraindications for microsurgery, accordingly to literature, pedicle flaps such as PMMC and FAMM, or submental artery island flap (SAIF) might be considered as good reconstructive options for this type of defect …”

Section: Discussionmentioning

confidence: 99%

“…24,39,40 In case of contraindications for microsurgery, accordingly to literature, pedicle flaps such as PMMC and FAMM, or submental artery island flap (SAIF) might be considered as good reconstructive options for this type of defect. [41][42][43][44] In comparison to type 2 defects, patients with type 3 defects require more extensive and complex resection, involving more than 50% of tongue volume ("Extended hemiglossectomy"). In other words, multiple tongue subunits are removed, sometimes requiring mandibulotomy or lip split for access, thus affecting form and mobile function considerably.…”

Section: Discussionmentioning

confidence: 99%

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Classification of tongue cancer resection and treatment algorithm

Mannelli

Arcuri

Agostini

et al. 2018

Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Classification of tongue cancer resection and treatment algorithm

Mannelli

Arcuri

Agostini

et al. 2018

Journal of Surgical Oncology

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“…The standard reconstruction approach for many head and neck abnormalities in the modern era is free tissue transfer. However, due to its speed, the PMMC is still a viable option to consider when vascularized soft tissue coverage is needed (Gangiti et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Various flap reconstruction options for tongue defect in oral squamous cell carcinoma

Narendra Wadewale,

Bhola,

Agarwal

2023

Med Sci

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Carcinoma of tongue cases is increasing in number day by day. An earlier diagnosis improves a person's chance of surviving five years after being diagnosed with tongue carcinoma. The primary therapeutic option for tongue squamous cell carcinoma is surgery. When evaluating the treatment plan, it is essential to consider the potential effects of such treatments on speech, swallowing, and cosmetic outcomes to get the first-rate loco-regional control rate. Following primary tumor removal, reconstruction should be done expeditiously. The degree of the residual tumor and the type of tongue replacement used to determine how severe the functional impairment will be.In this case series, we attempt to present our institutional data of 142 retrospective cases to highlight various commonly used flaps for tongue reconstruction based on the size of the defect.

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“…PMMC flaps requires minimal expertise and can be modified based on the dimensions required and is the workhorse flap in the head and neck reconstruction and can be easily harvested. [ 23 ] Studies by Hsing et al , Xiao et al , and O’Neill et al . showed that PMMC had no significant difference in pain, appearance, swallowing, chewing, and other functional aspects when compared with free flaps, ALT, and FRAFF respectively.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Functional and Survival Outcomes in Pedicled and Microsurgical Flap Reconstruction for Near-Total and Total Glossectomies

Dhakad

Saldanha

Patel

et al. 2022

Annals of Maxillofacial Surgery

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Introduction: Patients with advanced carcinoma tongue end up with near-total/total glossectomy (NTG/TG). We intended to compare functional, oncological, and survival outcomes of patients undergoing pedicled and microsurgical flap reconstruction in NTG/TG patients at our hospital. Methodology: A prospective study was conducted for 7 years on 91 patients with carcinoma tongue who underwent NTG/TG at our institute. Patients underwent anterolateral thigh (ALT), free radial artery forearm flap (FRAFF), and pectoralis major myocutaneous (PMMC) flap reconstruction and were followed up for immediate complications and functional outcomes for speech, swallowing, and decannulation after completion of adjuvant treatment and then for survival rates for a period of 60 months and statistically analysed with log rank test and Fisher’s exact test for correlation. Results: Ninety-one (42.85%) patients underwent NTG, while 57.14% underwent TG. 85% of patients had >5 mm margin, 14% had ≤ of 5 mm, and none were positive. 57% of patients did not have postoperative complications and 10% underwent re-exploration. During follow-up, 85.7% of patients were able to take orally: 52% soft diet and 32% liquid diet. Multivariate analysis of individual flaps, swallowing, and speech intelligibility values were significant. After 5 years of postadjuvant therapy, there was 76% overall survival, 11% local recurrence and 12% had regional recurrence. Discussion: Morbidity and functional outcome depends on the extent of resection. PMMC flaps can be done on lack of expertise. FRAFF has better functional outcomes owing to pliability of flap. ALT and other bulky flaps require expertise and are prone to flap-related complications. Planning of reconstruction should be based on the defect size together with counseling of patients regarding the risk of complications and delay in adjuvant therapy.

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Modified pectoralis major myocutaneous flap for the total glossectomy defects: Effect on quality of life

Abstract: Modified technique of reconstruction with PMMC in total glossectomy is a viable option with minimal functional morbidity. Quality of life in terms of tracheostomy and feeding tube dependency is minimal. J. Surg. Oncol. 2016;114:32-35. © 2016 Wiley Periodicals, Inc.

Cited by 12 publications

References 15 publications

Classification of tongue cancer resection and treatment algorithm

Classification of tongue cancer resection and treatment algorithm

Various flap reconstruction options for tongue defect in oral squamous cell carcinoma

Comparison of Functional and Survival Outcomes in Pedicled and Microsurgical Flap Reconstruction for Near-Total and Total Glossectomies

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