[Replantation of a traumatically amputated tongue]

We describe a successful composite graft of a 4.5 cm piece of an amputated tongue, performed without microvascular technique.

A young adult fell off his bicycle, resulting in a traumatic amputation of part of his tongue, approximately 4.5 cm from the tip. Microvascular expertise was not available but the otolaryngologist on duty was advised to proceed with non-vascular composite graft surgery. Postoperatively the tongue was ischaemic. Marginal blood flow was assessed with ultrasound and pulse oximetry, and surgical reamputation was deferred. Several treatments were initiated to facilitate tongue revitalisation and circulation, including hyperbaric oxygen. Five months postoperatively, the patient was able to protrude his tongue to his teeth, had no problems swallowing, had improved pronunciation, and had regained some sensibility and taste.

We strongly recommend microvascular surgery reimplantation when such competency is available, but in locations without this option we have demonstrated that a non-vascular approach with a composite graft can be attempted as a last resort.