The Modified "ICTM" technique for total tongue reconstruction using profund artery perforator flap

Area of Science:

• Head and Neck Surgery
• Reconstructive Surgery
• Oral Oncology

Background:

• Total tongue reconstruction presents significant surgical challenges.
• Achieving optimal functional outcomes necessitates free flaps with adequate volume and precise design.

Purpose of the Study:

• To evaluate the clinical utility of the modified Individualized and Convenient Tongue Model (ICTM) technique for total tongue reconstruction.
• To assess the efficacy of using profunda artery perforator flaps (PAPF) with the ICTM technique.

Main Methods:

• A retrospective study of 58 patients undergoing total tongue reconstruction with PAPFs (January 2018-December 2023).
• Comparison between 29 patients using the modified ICTM technique and 29 using conventional flap design.
• Assessment of functional and aesthetic outcomes using standardized scales and statistical analysis (p < 0.05).

Main Results:

• The modified ICTM technique resulted in neotongues with improved volume, contour, and sustained protuberance.
• Significant improvements were observed in speech intelligibility (p = 0.023), swallowing function (p = 0.008), and cosmetic appearance (p = 0.001) in the ICTM group.
• PAPFs designed with the modified ICTM technique demonstrated superior wound closure.

Conclusions:

• The modified ICTM technique with PAPFs provides superior outcomes for total tongue reconstruction.
• This technique enhances functional results, including speech and swallowing, and improves aesthetic appearance.
• The modified ICTM technique represents an advancement over conventional flap designs for complex tongue reconstructions.