J Reconstr Microsurg 2003; 19(3): 195-202
DOI: 10.1055/s-2003-39834
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Prelaminated Fasciomucosal Flap Using Tongue Mucosa in a Rat Model

Kang-Min Ahn, Myung-Jin Kim, Jong-Ho Lee
  • Department of Oral and Maxillofacial Surgery, Seoul National University Hospital, Seoul, South Korea
Further Information

Publication History

Publication Date:
13 June 2003 (online)

ABSTRACT

Reconstruction of tongue defects from various causes has been a continuing challenge to reconstructive surgeons. If tongue mucosa is used in tongue reconstruction, some disadvantages of cutaneous flaps can be overcome, and also some functions of the tongue, like handling, compressing, and macerating of food, can be improved. The purpose of this study was to assess the feasibility of a prelaminated fasciomucosal flap, using rat tongue mucosa. The survival rate of prelamination and revascularization of the dorsal tongue mucosa graft was evaluated. Changes in the epithelial cell layer and tongue papilla over time were observed. Tongue mucosa graft prelamination was feasible in most cases, and the survival rate was 83.3 percent. The number of microvessels increased with time, and statistically significant positive correlations were observed (Spearman rank correlation rs=0.709 p<0.05). The results validated that it is possible to fabricate a fasciomucosal flap using tongue mucosa. However, the prelaminated flap should be transferred to the recipient site between 10 and 14 days after prelamination, to maintain the papillary morphology of the tongue.

REFERENCES

  • 1 Brown J S. T2 tongue : reconstruction of the surgical defect.  Br J Oral Maxillofac Surg . 1999;  37 194-199
  • 2 Urken M L. The restoration or preservation of sensation in the oral cavity following ablative surgery.  Arch Otolaryngol Head Neck Surg . 1995;  121 607-612
  • 3 Millesi W, Rath T, Millesi-Schobel G, Glaser C. Reconstruction of the floor of the mouth with a fascial radial forearm flap, prelaminated with autologous mucosa.  Int J Oral Maxillofac Surg . 1998;  27 106-110
  • 4 Rath T, Millesi W, Millesi-Schobel G. et al . Mucosal prelaminated flaps for physiological reconstruction of intraoral defects after tumor resection.  Br J Plast Surg . 1997;  50 303-307
  • 5 Rath T, Millesi W, Millesi-Schobel G, Lang S. Mucosal prelamination of a radial forearm flap for intraoral reconstruction.  J Reconstr Microsurg . 1997;  13 507-513
  • 6 Akyurek M, Safak T, Kayikcioglu A. A new flap model in the rat: the pectoral skin flap.  Ann Plast Surg . 1999;  42 185-192
  • 7 Philipsen H P, Peter C J, Fisker A V. Correlative light microscopic and scanning electron microscopic study of completely and incompletely orthokeratinized rat oral epithelium.  Scand J Dent Res . 1982;  90 255-262
  • 8 Bosari S, Lee A KC, Delellis R A. Microvessel quantitation and prognosis in invasive breast carcinoma.  Hum Pathol . 1992;  23 755-761
  • 9 Jacobson M C, Franssen E, Fliss D M. Free forearm flap in oral reconstruction.  Arch Otolaryngol Head Neck Surg . 1995;  121 959-964
  • 10 Mehta S, Sarkar S, Kavarana N. Complications of the pectoralis major myocutaneous flap in the oral cavity : a prospective evaluation of 220 cases.  Plast Reconstr Surg . 1996;  98 31-77
  • 11 Yang G F, Chen P J, Gao Y Z. Classic reprint-Forearm free skin flap transplantation : a report of 56 cases.  Br J Plast Surg . 1997;  50 162-165
  • 12 Lyos A T, Evans G RD, Perez D, Schusterman M A. Tongue reconstruction: outcomes with the rectus abdominis flap.  Plast Reconstr Surg . 1999;  103 442-449
  • 13 Soutar D S, McGregor I A. The radial forearm flap in intraoral reconstruction : the experience of 60 consecutive cases.  Plast Reconstr Surg . 1986;  78 1-8
  • 14 Reuther J F, Steinau H U, Wagner R. Reconstruction of large defects in the oropharynx with a revascularized intestinal graft: an experimental and clinical report.  Plast Reconstr Surg . 1984;  73 345-357
  • 15 Theile D R, Robinson D W, Theile D E, Coman W B. Free jejunal interposition reconstruction after pharyngolaryngectomy: 201 consecutive cases.  Head Neck . 1995;  17 83-88
  • 16 Pribaz J J, Fine N A. Prelamination: defining the prefabricated flap-A case report and review.  Microsurgery . 1994;  15 618-623
  • 17 Pribaz J J, Weiss D D, Mulliken J B, Eriksson E. Prelaminated free flap reconstruction of complex central facial defects.  Plast Reconstr Surg . 1999;  104 357-365
  • 18 Pribaz J J, Fine N, Orgill D P. Flap prefabrication in the head and neck: a 10-year experience.  Plast Reconstr Surg . 1999;  103 808-820
  • 19 Erol OÖ. The transformation of a free skin graft into a vascularized pedicled flap.  Plast Reconstr Surg . 1976;  58 470-477
  • 20 Haller J A, Billingham R E. Studies of the origin of the vasculature in free skin graft.  Ann Surg . 1967;  166 896-901
  • 21 Tavis M J, Thornton J W, Harney J H. Graft adherence to de-epithelialized surfaces: a comparative study.  Ann Surg . 1976;  184 594-600
  • 22 Fisseler-Eckhoff A, Müller K M. Histological examination of the skin grafts. In: Altmeyer P, Hoffmann K, Gammal SE (eds) Wound Healing and Physiology. Berlin, Heidelberg, New York: Springer-Verlag 1995: 33-43
  • 23 Hira M, Tajima S. Biochemical study on the process of skin graft take.  Ann Plast Surg . 1992;  29 47-54
  • 24 Cordeiro P G, Santamaria E, Hu Q Y. The timing and nature of neovasculariztion of jejunal free flaps: an experimental study in a large animal model.  Plast Reconstr Surg . 1999;  103 1893-1901
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