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Fabrication of Tongue Extracellular Matrix and Reconstitution of Tongue Squamous Cell Carcinoma In Vitro
Published on: June 20, 2018
Secondary microvascular tongue reconstruction: functional results
A H Salibian1, G R Allison, V V Strelzow
1Center for Disorders of the Head and Neck, Western Medical Center, Santa Ana, California.
Head & Neck
|September 1, 1993
Summary
Primary oromandibular reconstruction using microvascular flaps offers superior swallowing and speech outcomes compared to delayed reconstructions. Delayed procedures show limited functional improvement due to scarring and muscle damage.
Area of Science:
- Oral and Maxillofacial Surgery
- Reconstructive Surgery
- Swallowing Disorders
Background:
- Oromandibular reconstruction frequently requires microvascular composite flaps.
- Evaluating functional outcomes of primary versus secondary reconstructions is crucial.
Purpose of the Study:
- To compare the functional outcomes of primary versus secondary microvascular flap reconstructions for oromandibular defects.
- To assess the impact of reconstruction timing on swallowing and speech.
Main Methods:
- Retrospective analysis of 56 microvascular composite flap reconstructions between 1978 and 1991.
- Categorization into primary (15 tongue) and secondary (5 tongue) reconstructions.
- Functional assessment of swallowing and speech post-reconstruction.
Main Results:
- Primary reconstructions demonstrated superior swallowing (8/10 with dynamic oral transport, no aspiration) and speech.
- Secondary reconstructions showed improved intraoral food transport (3/5) but persistent aspiration (3/4).
- Scarring and muscle damage in secondary cases likely contributed to poorer functional results.
Conclusions:
- Primary microvascular oromandibular reconstruction yields better functional outcomes than secondary reconstruction.
- Delayed reconstruction may not fully restore swallowing and speech due to irreversible tissue changes.
- Floor of the mouth composite bone grafting offers partial improvement but does not eliminate aspiration in secondary cases.
