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Modified Heterotopic Hindlimb Osteomyocutaneous Flap Model in the Rat for Translational Vascularized Composite Allotransplantation Research
Published on: April 26, 2019
Functional hemitongue reconstruction with the microvascular ulnar forearm flap
A H Salibian1, G R Allison, W B Armstrong
1Department of Otolaryngology, University of California Irvine Medical Center, Orange, USA. eatakaha@UCI.edu
Plastic and Reconstructive Surgery
|August 24, 1999
Summary
This study on tongue cancer reconstruction found that a narrow tongue root and ample floor of mouth space improve swallowing and speech. Optimal reconstruction shapes are key for functional recovery after hemitongue resection.
Area of Science:
- Head and Neck Surgery
- Oral Oncology
- Microsurgery
Background:
- Squamous cell carcinoma of the tongue often requires extensive resection, impacting function.
- Reconstruction aims to restore tongue form and function, including speech and swallowing.
- Microvascular free flaps offer robust solutions for complex head and neck defects.
Purpose of the Study:
- To evaluate the functional outcomes of tongue reconstruction using ulnar forearm flaps.
- To identify anatomical factors influencing speech and swallowing post-reconstruction.
- To correlate reconstruction techniques with functional recovery in tongue cancer patients.
Main Methods:
- Thirteen patients with tongue cancer underwent hemitongue resection and microvascular reconstruction with ulnar forearm flaps.
- Six patients had composite resections with iliac crest grafts for mandibular reconstruction.
- Functional outcomes (speech, swallowing) were assessed using dietary analysis, cineradiography, and voice analysis.
Main Results:
- Nine patients with a narrow tongue root and large floor of mouth area achieved good tongue mobility and oral transport.
- Three patients with a wide tongue root and ill-defined floor of mouth had impaired mobility and oral transport.
- Functional outcomes strongly correlated with tongue root shape, palate proximity, and floor of mouth surface area.
Conclusions:
- The shape of the reconstructed tongue root and the surface area of the floor of mouth are critical for functional recovery.
- Optimizing these anatomical features during microvascular reconstruction can improve speech and swallowing in tongue cancer patients.
- This study highlights the importance of detailed flap design for functional outcomes in tongue reconstruction.
