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Journal of the Korean Society of Plastic and Reconstructive Surgeons 2006;33(5):557-562.
Published online September 1, 2006.
Analysis of Free Flap Reconstruction of the Tongue.
Dong Hee Kang, Hyung Chul Lee, Sang Hwan Koo, Seung Ha Park, Kwang Yoon Jung
1Department of Plastic and Reconstructive Surgery, Dankook University College of Medicine, Chungchoengnam-do, Korea. dhkcool@korea.ac.kr
2Department of Plastic and Reconstructive Surgery, Korea University College of Medicine, Seoul, Korea.
3Department of Otolaryngology, Korea University College of Medicine, Seoul, Korea.
Abstract
PURPOSE
Advanced carcinoma of the tongue is a devastating disease which may cause severe speech or swallowing dysfunction. But, none to date has provided all of the complex functions of the tongue. The purpose of this study is to review our experiences with individuals who underwent glossectomy followed by reconstruction using free tissue transfer. METHODS: Between February 1998 and February 2005, twenty-four patients underwent glossectomy followed by free tissue transfer reconstruction. The defects of tongue caused by partial or subtotal glossectomy were reconstructed by means of radial forearm or lateral thigh free flap with nerve innervation. Especially for the patients who underwent total glossectomy, we reconstructed deglutition muscles anatomically with nerve reinnervation, a procedure that allows the grafted muscle to maintain good tongue bulk without obvious atrophy.
RESULTS
Patients were reviewed to determine their functional outcome as it related to speech, deglutition, and aspiration. All patients achieved oral intake of a soft diet and acceptable speech.
CONCLUSION
Although reconstruction following glossectomy using free tissue transfer is not ideal, this procedure is safe and reliable, and provides predictable results. A future challenge is the development of a surgical procedure for reconstruction of a tongue that maintains mobility and sensation using neurotized flaps.
Keywords: Tongue cancer; Free flap reconstruction
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