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Related Experiment Videos

Tongue reconstruction: concepts and practice

B H Haughey1

  • 1Department of Otolaryngology, Washington University School of Medicine, St. Louis, MO 63110.

The Laryngoscope
|October 1, 1993
PubMed
Summary
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A novel latissimus dorsi flap design improves speech and swallowing after tongue cancer surgery. This innovative technique offers better articulation and oral intake for patients undergoing glossectomy.

Area of Science:

  • Reconstructive Surgery
  • Head and Neck Surgery
  • Microsurgery

Background:

  • Total or subtotal tongue resection can lead to severe speech and swallowing dysfunction, increasing aspiration risk.
  • Current reconstructive methods may not fully restore function after glossectomy.
  • Latissimus dorsi flaps are versatile for reconstruction but require specific design for neotongue function.

Purpose of the Study:

  • To develop and evaluate a new design for latissimus dorsi flaps for tongue reconstruction.
  • To create a contractile muscle sling to improve neotongue function for speech and swallowing.
  • To assess the functional outcomes of this innovative flap in patients undergoing glossectomy.

Main Methods:

  • Harvesting latissimus dorsi flaps with muscle fibers oriented transversely to enhance contractility.

Related Experiment Videos

  • Transferring the flap to the oral and oropharyngeal defect, suturing to mastication muscles.
  • Performing microvascular anastomosis and hypoglossal nerve reinnervation.
  • Utilizing the skin component to create an articulating mound in the floor of the mouth.

    • Main Results:

    • Successfully reconstructed 14 patients undergoing glossectomy for cancer.
    • Achieved an 80% decannulation rate, preserving the larynx in most cases.
    • 70% of patients could tolerate pureed food or a better diet.
    • Demonstrated improved articulation and documented upward flap motion via video swallowing studies.

    Conclusions:

    • The innervated latissimus dorsi flap with transverse muscle orientation is a viable and effective method for functional rehabilitation after total or subtotal glossectomy.
    • This technique significantly improves speech, swallowing, and oral intake.
    • Offers a promising solution for patients with extensive tongue defects due to cancer.