Reconstruction of the tongue

Area of Science:

• Head and Neck Surgery
• Surgical Oncology
• Reconstructive Surgery

Background:

• Subtotal or total glossectomies for tongue malignancies present significant postoperative functional deficits.
• Traditional reconstruction methods often yield suboptimal functional results.
• Advancements in myocutaneous flap techniques offer new possibilities for tongue reconstruction.

Observation:

• A novel approach for functional tongue reconstruction is presented.
• This technique utilizes a superiorly based sternocleidomastoid myocutaneous flap.
• Neurorrhaphy between the hypoglossal nerve and the nerve to the sternocleidomastoid muscle is facilitated due to nerve proximity.

Findings:

• The sternocleidomastoid myocutaneous flap is well-suited for tongue reconstruction due to its composition (no intervening fat) and bulk.
• The flap's characteristics closely mimic native tongue muscle.
• A patient treated with this method demonstrated full tongue movement 11 months postoperatively.

Implications:

• This technique represents a promising advancement in functional tongue reconstruction following major resections.
• Improved functional outcomes, including preserved tongue movement, can be achieved.
• This approach may enhance the quality of life for patients undergoing glossectomy for cancer or other conditions.