Tongue reconstruction: Rebuilding mobile three‐dimensional structures from immobile two‐dimensional substrates, a fresh cadaver study

Abstract

Objective To determine the two‐dimensional (2D) characteristics of flaps necessary to create three‐dimensional (3D) tongue anatomy. Methods Dissection of 11 fresh, nonpreserved human cadavers was performed. Six defects in each were created: total tongue, total oral tongue, hemiglossectomy, oral hemiglossectomy, total base of tongue, and hemi‐base of tongue. The resections were debulked to create flat, 2D mucosal flaps. The dimensions and shapes of these flaps were determined. Results Each specimen showed consistent dimensions and geometry between cadavers. The total tongue was pear‐shaped, the total oral tongue was egg‐shaped, the oral hemi‐tongue was bullet‐shaped, the hemi‐tongue resembled a dagger, the total base of tongue was rectangular, and the hemi‐base of tongue was hour‐glass shaped. Conclusion Typical dimensions and shapes of common tongue defects were determined. It is conceivable that customizing reconstructive flaps based on these data will increase the accuracy of neo‐tongue reconstruction, and thus, improve functional outcomes.

Radial Forearm Free Flap for Tongue Reconstruction

“…As a result, oncological surgery with immediate reconstruction has the goal of restoring the shape and function of the resected parts beyond closing resection defects [9] . The tongue is one of the most challenging structures to properly reconstruct because glossectomy causes significant functional deficits due to the intricate tongue anatomy within a relatively small space [10][11] . Studies have shown that the effectiveness of current reconstructive efforts to restore tongue function directly affects patients' Quality of Life (QoL) and their ability to return to normal activities and interaction in society [12] .…”