J Reconstr Microsurg 2003; 19(3): 137-142
DOI: 10.1055/s-2003-39824
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Tongue Reconstruction with Free Radial Forearm Flap After Hemiglossectomy: A Functional Assessment

Hung-Tao Hsiao1,2 , Yi-Shing  Leu3 , Chang-Ching Lin4
  • 1Division of Plastic Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan
  • 2Mackay Junior College of Nursing, Taipei, Taiwan
  • 3Department of Otolaryngology, Mackay Memorial Hospital, Taipei, Taiwan
  • 4Department of Speech Therapy, Mackay Memorial Hospital, Taipei, Taiwan
Further Information

Publication History

Publication Date:
13 June 2003 (online)

ABSTRACT

Thirty-three patients with squamous cell carcinoma of the anteriolateral part of the tongue underwent a 50 percent resection of the tongue. The surgical defect was reconstructed with a microvascular radial forearm flap. All the flaps were especially designed to have a narrow waist, shaped like an omega in cross-section, thus allowing for a free tongue tip, and avoiding suturing the edge of the flap to the soft palate and tongue base.

Sixteen patients were evaluated for swallowing and speech function at least 6 months following reconstruction. With this technique, the majority of the patients had nearly normal deglutition, although their speech was still unsatisfactory. However, the speech function in this series was better than that in other reported series.

REFERENCES

  • 1 Spiro R H, Strong E W. Surgical treatment of cancer of the tongue.  Surg Clin North Am . 1974;  54 759-765
  • 2 Schusterman M A, Kroll S S, Weber R S. Intraoral soft tissue reconstruction after cancer ablation: a comparison of the pectoralis major flap and the free radial forearm flap.  Am J Surg . 1991;  162 397
  • 3 Freedlander E, Espie C A, Campsie L M. Functional implication of major surgery for intraoral cancer.  Br J Plast Surg . 1989;  42 266
  • 4 Sultan M R. Reconstruction of the base of the tongue with the microvascular ulnar forearm flap: a functional assessment (discussion).  Plast Reconstr Surg . 1994;  96 1090-1091
  • 5 Sultan M R, Coleman J J. Oncologic and functional considerations of total glossectomy.  Am J Surg . 1989;  158 297-302
  • 6 Teichgraeber J, Bowman J, Goepfert H. New test series for the functional evaluation of oral cavity cancer.  Head Neck Surg . 1985;  8 9-20
  • 7 Dios D P, Feijoo J F, Ferreiro C. Functional considerations of partial glossectomy.  J Oral Maxillofac Surg . 1994;  52 12-14
  • 8 Soutar M R. The radial forearm flap in intraoral reconstruction: the experience of 60 consecutive cases.  Plast Reconstr Surg . 1986;  78 1-8
  • 9 Bakamijian V Y, Long M, Rigg B. Experience with the medially based deltopectoral flap in reconstruction surgery of the head and neck.  Br J Plast Surg . 1971;  24 174
  • 10 McGregor I A. The temporal flap in intraoral cancer: its use in repairing the postexcisional defect.  Br J Plast Surg . 1963;  16 318
  • 11 McGregor I A. Fasciocutaneous flaps in intraoral reconstruction.  Clin Plast Surg . 1985;  12 453-461
  • 12 Takato T, Harii K, Ebihara S. Oral and pharyngeal reconstruction using the free forearm flap.  Arch Otolaryngol Head Neck Surg . 1987;  113 873-879
  • 13 Salibian A H, Allison G R, Krugman M E. Reconstruction of the base of the tongue with the microvascular ulnar forearm flap: a functional assessment.  Plast Reconstr Surg . 1995;  96 1081-1089
  • 14 Salibian A H, Allison G R, Strelzon VV: Secondary microvascular tongue reconstruction: functional results. Head Neck .  1993;  15 389-397
  • 15 Roberts R I. A cineradiographic investigation of pharyneal deglutition.  Br J Radiol . 1957;  357 449
  • 16 Matloub H S, Larson D L, Kuhn J C. Lateral arm free flap on oral cavity reconstruction: a functional evaluation.  Head Neck . 1989;  11 205-211
  • 17 Hamlet S, Jones L, Patteson R. Swallowing recovery following anterior tongue and floor of mouth surgery.  Head Neck . 1991;  13 334-339
  • 18 Hamlet S L, Mathog R H, Patterson R L. Tongue mobility in speech after partial glossectomy.  Head Neck . 1990;  12 210-217
  • 19 Harrison L B, Zelefsky M J, Sessions R B. Base-of-tongue treated with external beam irradiation plus brachytherapy: oncologic and functional outcome.Radiology .  1992;  184 267-270
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