Oral tongue reconstruction

Archibald, Stuart; Gupta, Michael; Thoma, Achilleas

doi:10.1002/9781118655412.ch25

Cited by 3 publications

(6 citation statements)

References 70 publications

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“…The facial artery myomucosal flap is only suitable for modest-sized defect. 1 Thus, with larger than 33% oral tongue defect, regional flaps and free flaps are preferable.…”

Section: Discussionmentioning

confidence: 99%

“…Although the main goal of hemiglossectomy reconstruction is the restoration of the "finger-like" function, the primary goal of near-total and total glossectomy reconstruction is to restore resected volume. The Functional Oral Intake Scale (1)(2)(3)(4)(5)(6)(7). Levels 1 to 3 tube dependent: 3, tube dependent with consistent oral intake of food or liquid.…”

Section: Discussionmentioning

confidence: 99%

“…The tongue is an organ that cannot be regenerated as simply “filling a hole” but must be reconstructed aesthetically and functionally after treatment. To achieve this, there must be a combination of surgeons, dentists, orthodontists, speech therapists, radiologists, nurses, and other relevant specialties 1 …”

mentioning

confidence: 99%

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Twelve Years of Establishing the Strategies for Tongue Reconstruction

Nguyen

2023

Ann Plast Surg

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Background Reconstruction after resection of malignant tongue tumors remains one of the most difficult problems in head and neck oncology. Recent trends in tongue reconstruction have focused on optimizing speech and swallowing functions and maximizing quality of life. In the recent literature, several reconstructive strategies including regional flaps and free flaps have been described. Patients and Methods A case series of 328 patients underwent oral tongue reconstruction between March 2011 and March 2022. Functional evaluation was performed in all patients 3 months after reconstruction (where the patients required no adjuvant radiotherapy) or after radiotherapy. Results Total flap necrosis was seen in 5 patients with free flap reconstruction (2 radial forearm flaps, 1 lateral arm flap, and 2 anterolateral thigh flaps), 5 patients with infrahyoid myocutaneous flap, and 1 patient reconstructed with a supraclavicular flap. Our success rate is 96.6%; partial flap necrosis was observed in 11 patients with infrahyoid myocutaneous flap and 2 patients with a supraclavicular flap. Most patients with subtotal glossectomy or smaller defects (type II–IVA defects) could communicate on the phone and had the near-normal capacity for an oral diet. The remaining patients (type IVB–V defects) had significantly lower speech scores. The majority of patients could eat liquid and semiliquid foods. Conclusion Tongue cancer surgery and subsequent reconstruction posed exciting challenges for the surgeon to optimize tongue function and quality of life for patients. Attention to the principles of tongue reconstruction and choosing appropriate flap for each defect achieve better functional results.

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“…The facial artery myomucosal flap is only suitable for modest-sized defect. 1 Thus, with larger than 33% oral tongue defect, regional flaps and free flaps are preferable.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Twelve Years of Establishing the Strategies for Tongue Reconstruction

Nguyen

2023

Ann Plast Surg

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“…This flap is a robust, predominantly hairless and is adequate option for moderate‐sized oral cavity defects. Raising IHMCF does not carry the same risk of violating the principles of an oncologic dissection as may can occur with the dissection required for a pedicled submental island flap 7 …”

Section: Discussionmentioning

confidence: 99%

“…Raising IHMCF does not carry the same risk of violating the principles of an oncologic dissection as may can occur with the dissection required for a pedicled submental island flap. 7 …”

Section: Discussionmentioning

confidence: 99%

Vein preservation strategies to improve the survival rate of the infrahyoid musculocutaneous flap

Nguyen

Ngo

Nguyen

et al. 2021

Laryngoscope Investig Oto

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The infrahyoid musculocutaneous flap (IHMCF) is a good alternative in the reconstruction of moderate‐sized oral cavity surgical defects. Insufficient venous drainage can significantly affect the survival rate of this flap. Objectives Identify the survival rates of the IHMCF and evaluate the functional capacity of reconstructed patients. Design We report a case series. Setting This study took place at the Department of Head and Neck Surgery of Oncology Hospital Ho Chi Minh City, the largest oncology center in South Vietnam. Participants One hundred and twelve patients with surgical defects after oral cavity resection for cancer underwent IHMCF reconstruction from November 2013 to November 2018. During the harvest of the flap, our modification of the surgical technique specifically attempted to preserve more secondary veins for IHMCF. Main Outcome Measures Postoperative viability of the flap was checked by clinical observation. The last examination was performed at 3‐months after reconstructive operation or after the completion of adjuvant radiotherapy. The functional capacity of our patients was evaluated by three physicians (Head and Neck Surgeon, Radiation Oncologist, and Physiatrist) with understandability of speech scale and the functional oral intake score items assessed. Results Two cases of partial skin necrosis (1.8%) were experienced. The majority of patients demonstrated favorable functional rehabilitation at long‐term follow up. Conclusions The IHMCF is a reliable flap suitable for moderate‐sized defects of the oral cavity. Altering the surgical approach to specifically preserve more venous outflow can improve the survival rate of the flap. Level of Evidence 4.

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