[Dynamic tongue reconstruction with reinnervated free gracilis muscle flap]

At our center, free flap reconstruction is the gold standard after subtotal or total glossectomy performed for oncological indications. In microvascular reconstructive surgery, several factors must be considered when selecting a flap. In the absence of a flap that meets all requirements perfectly, we strive to restore the functions that most significantly affect the quality of life. Removal of the tongue causes significant impairment of speech, swallowing, and taste sensation. A free flap containing a reinnervated muscle may be suitable for restoring partial tongue movements. Our report presents the use of a reinnervated gracilis musculocutaneous free flap following subtotal glossectomy. During free tissue transplantation, a tissue block removed from another part of the body is transplanted along with its supplying microvessels and nerves using microsurgical techniques. In addition to our standard postoperative management protocol, the flap healed uneventful, and oral feeding was fully restored on the 28th postoperative day. Images and swallowing X-ray taken 8 months postoperatively show the neotongue moving in a cranio-caudal direction. This is the first report of this method in the Hungarian literature. The dynamic movement and volume preservation of the transplanted muscle flap may prevent functional loss, thereby positively affecting the quality of life after treatment. Orv Hetil. 2026; 167(44): 1785-1789.