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Reconstruction of Tongue Malignancy Defects: A Systematic Review and Treatment Algorithm.
Peter F Gearing1,2, Maxim Devine1, Felix Sim3
1Department of Plastic & Reconstructive Surgery, The Royal Melbourne Hospital, Melbourne, Australia.
Microsurgery
|June 12, 2025
Summary
This review synthesizes outcomes of tongue reconstruction methods to aid surgical planning for tongue cancer. It identifies common flap techniques like anterolateral thigh (ALT) and radial forearm free flaps (RFFF).
Area of Science:
- Oral surgery
- Reconstructive surgery
- Oncology
Background:
- Tongue cancer is the most common oral malignancy, with surgical resection being the primary treatment.
- Tongue cancer resection significantly impacts speech and swallowing functions.
- Effective reconstruction aims to restore function with minimal morbidity.
Purpose of the Study:
- To review and synthesize published outcomes of tongue reconstructive methods.
- To develop a clinical treatment algorithm for tongue reconstruction.
Main Methods:
- A systematic electronic search was performed across multiple databases (Medline, Embase, PubMed, CENTRAL) up to October 12th, 2024.
- Studies were screened, and quantitative data from 113 included papers were extracted.
- Exclusion criteria included conference abstracts, case reports, case series, and review papers.
Main Results:
- 113 papers were included in the review, identifying various reconstructive methods.
- Commonly identified methods include free flaps, locoregional flaps, skin grafting, and tissue substitutes.
- The anterolateral thigh (ALT) free flap and radial forearm free flap (RFFF) were the most frequently used reconstructive techniques.
Conclusions:
- A treatment algorithm is proposed to guide surgical planning and decision-making for tongue cancer defects.
- This algorithm aims to optimize reconstructive strategies for improved functional outcomes.
- PROSPERO Registration: CRD420223818875.
