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Updated: May 25, 2026

Learning Modern Laryngeal Surgery in a Dissection Laboratory

Learning Modern Laryngeal Surgery in a Dissection Laboratory

Published on: March 18, 2020

[Functional reconstruction after total or near total glossectomy].

Jun-yi Wang¹, Bin Zhang, De-zhi Li

¹Department of Head and Neck Surgery, Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100021, China.

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi = Chinese Journal of Otorhinolaryngology Head and Neck Surgery

|February 11, 2012

Summary

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Maintaining mandibular continuity is key for oral feeding recovery after total or near-total glossectomy. Free flaps (FF) offer better outcomes than pectoralis major myocutaneous flaps (PMMF) by aiding mandibular reconstruction.

Area of Science:

Head and Neck Surgery
Reconstructive Surgery
Oncology

Background:

Total or near-total glossectomy is a major surgical procedure for advanced oral cancers.
Reconstruction is crucial for restoring function after extensive tongue resection.
Pectoralis major myocutaneous flap (PMMF) and free flap (FF) are common reconstructive options.

Purpose of the Study:

To compare the functional outcomes of pectoralis major myocutaneous flap (PMMF) versus free flap (FF) reconstruction after total or near-total glossectomy.
To identify factors influencing functional recovery, particularly oral feeding and speech.
To evaluate the impact of mandibular integrity on functional outcomes.

Main Methods:

Retrospective analysis of 38 patients undergoing total or near-total glossectomy.

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Comparison of outcomes between PMMF and FF reconstruction groups.

Assessment of decannulation, oral feeding, and speech function recovery.

Main Results:

Free flap reconstruction showed significantly better oral feeding recovery (100%) compared to PMMF (65.2%).
Tracheostomy decannulation rates were also higher with FF (100%) versus PMMF (52.2%).
Mandibular continuity was identified as the sole independent predictor for successful oral feeding restoration.

Conclusions:

Mandibular continuity is paramount for functional recovery, especially oral feeding, post-glossectomy.
Free flap reconstruction is more advantageous than PMMF for preserving or rebuilding mandibular continuity.
Optimizing reconstruction strategies to maintain mandibular integrity is essential for improving patient outcomes.