Successful revascularization following near-complete amputation of the tongue

Successful salvage of the tongue following near or complete traumatic amputation is a rare event. We now report only the second reported successful case of a revascularization of a near or complete amputation of the tongue while in the setting of massive facial trauma. Microscopic revascularization was performed utilizing the left lingual artery and right lingual vein, and despite a prolonged ischemic period, a functional tongue was salvaged. Our patient demonstrated that the tongue can survive up to 16 hours of ischemia. The successful replantation also suggests that arterial blood flow through a single lingual artery and a contralateral single vein may be adequate to perfuse the entire mobile tongue, despite the previously thought avascular median fibrous septum. Tongue revascularization can be performed in the setting of massive facial trauma and large-volume fluid resuscitation.