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Total and subtotal glossectomy: function after microvascular reconstruction.

A H Salibian1, G R Allison, I Rappaport

  • 1Center for Disorders of the Head and Neck, Western Medical Center, Santa Ana, Calif.

Plastic and Reconstructive Surgery
|April 1, 1990
PubMed
Summary
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This study evaluated microvascular composite groin flaps for tongue and floor of mouth cancer reconstruction. Results show improved speech and swallowing function, enabling better quality of life for patients.

Area of Science:

  • Head and Neck Surgery
  • Reconstructive Surgery
  • Oncology

Background:

  • Advanced carcinoma of the tongue and floor of mouth often requires extensive surgical resection.
  • Reconstruction following glossectomy and mandibulectomy presents challenges in restoring function.
  • Microvascular free flaps offer a solution for complex tissue defects.

Purpose of the Study:

  • To assess the efficacy of microvascular composite groin flaps in reconstructing the tongue and floor of mouth after cancer resection.
  • To evaluate functional outcomes, including speech and swallowing, in patients undergoing this reconstructive procedure.

Main Methods:

  • Twelve patients with advanced oral cancer underwent glossectomy and partial mandibulectomy.
  • Immediate reconstruction was performed using microvascular composite groin flaps (osteomusculocutaneous in 11, osteomuscular in 1).

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  • Functional outcomes (speech, swallowing) were evaluated in survivors >1 year using clinical assessment and cinefluorography.

    • Main Results:

    • Eight of 12 patients survived >1 year and were assessed.
    • Eight patients achieved intelligible speech.
    • Six patients could tolerate a soft/pureed diet; two were limited to fluids.
    • Cinefluorography revealed effective intraoral transport and pharyngeal emptying without aspiration in six patients with good flap-to-palate contact.

    Conclusions:

    • Microvascular composite groin flaps are effective for reconstruction after oral cancer surgery.
    • The flap design can restore dynamic food transport, improving swallowing and speech.
    • Successful outcomes depend on adequate flap-to-palate contact for functional restoration.