Fasciocutaneous Flap Reconstruction of the Tongue and Floor of Mouth: Outcomes and Techniques | Head and Neck Cancer | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 35.153.100.128. Please contact the publisher to request reinstatement.
1.
Massengill Jr  RMagwell  SPickrell  K An analysis of articulation following partial and total glossectomy.  J Speech Hear Disord.1970;35:170-173.Google Scholar
2.
Aguiliar  NVOlsen  MLShedd  DP Rehabilitation of deglutition problems in patients with head and neck cancer.  Am J Surg.1979;138:501-507.Google Scholar
3.
Gourin  CGJohnson  JT Surgical treatment of squamous cell carcinoma of the base of tongue.  Head Neck.2001;23:653-660.Google Scholar
4.
Soutar  DSMcGregor  IA The radial forearm flap in intraoral reconstruction: the experience of 60 consecutive cases.  Plast Reconstr Surg.1986;78:1-8.Google Scholar
5.
Urken  MLMoscoso  JFLawson  W  et al A systematic approach to functional reconstruction of the oral cavity following partial and total glossectomy.  Arch Otolaryngol Head Neck Surg.1994;120:589-601.Google Scholar
6.
Hayden  REDeschler  DG Lateral thigh free flap for head and neck reconstruction.  Laryngoscope.1999;109:1490-1494.Google Scholar
7.
David  D Use of an innervated deltopectoral flap for intraoral reconstruction.  Plast Reconstr Surg.1977;60:377-380.Google Scholar
8.
Matloub  HSLarsen  DLKuhn  JCYousif  NJSanger  JR Lateral arm free flap in oral cavity reconstruction: a functional evaluation.  Head Neck.1989;11:205-211.Google Scholar
9.
Urken  MLWeinberg  HVickery  CBiller  HF The neurofasciocutaneous radial forearm flap in head and neck reconstruction: a preliminary report.  Laryngoscope.1990;100(2, pt 1):161-173.Google Scholar
10.
Boyd  BMulholland  SGullane  P  et al Reinnervated lateral antebrachial cutaneous neurosome flaps in oral reconstruction: are we making sense?  Plast Reconstr Surg.1994;93:1350-1359.Google Scholar
11.
Kuriakose  MALoree  TRSpies  AMeyers  SHicks Jr  WL Sensate radial forearm free flaps in tongue reconstruction.  Arch Otolaryngol Head Neck Surg.2001;127:1463-1466.Google Scholar
12.
Haughey  BH Tongue reconstruction: concepts and practice.  Laryngoscope.1993;103:1132-1141.Google Scholar
13.
Adatia  AKGehring  EN Proprioceptive innervation of the tongue.  J Anat.1971;110:215-220.Google Scholar
14.
Salassa  JR A functional outcome swallowing scale for staging oropharyngeal dysphagia.  Dig Dis.1999;17:230-234.Google Scholar
15.
Davis  HSilverman  SR CID Everyday Sentence Test, Hearing and Deafness. 4th ed. New York, NY: Holt Rinehart & Winston Inc; 1978:537-538.
16.
Salibian  AHAllison  GRKrugman  ME  et al Reconstruction of the base of the tongue with the microvascular ulnar forearm flap: a functional assessment.  Plast Reconstr Surg.1995;96:1081-1089.Google Scholar
17.
Urken  MLBiller  HF A new bilobed design for the sensate radial forearm flap to preserve tongue mobility following significant glossectomy.  Arch Otolaryngol Head Neck Surg.1994;120:26-31.Google Scholar
18.
Lyos  ATEvans  GRPerez  DSchusterman  MA Tongue reconstruction: outcomes with the rectus abdominis flap.  Plast Reconstr Surg.1999;103:442-447.Google Scholar
19.
Weber  RAOhlms  LBowman  JJacob  RGoepfert  H Functional results after total or near total glossectomy with laryngeal preservation.  Arch Otolaryngol Head Neck Surg.1991;117:512-515.Google Scholar
20.
Yamamoto  YSugihara  TFuruta  YFukuda  S Functional reconstruction of the tongue and deglutition muscles following extensive resection of tongue cancer.  Plast Reconst Surg.1998;102:993-998; discussion 999-1000.Google Scholar
21.
Imai  SMichi  K Articulatory function after resection of the tongue and floor of the mouth: palatometric and perceptual evaluation.  J Speech Hear Res.1992;35:68-78.Google Scholar
22.
Fletcher  SA Speech production following partial glossectomy.  J Speech Hear Disord.1988;53:232-238.Google Scholar
23.
Pauloski  BRLogemann  JARademaker  AW  et al Speech and swallowing function after oral and oropharyngeal resections: one-year follow-up.  Head Neck.1994;16:313-322.Google Scholar
24.
Schlienphake  HSchmelzeisen  RSchonweiler  RSchneller  TAltenbernd  C Speech, deglutition and life quality after intraoral tumour resection: a prospective study.  Int J Oral Maxillofac Surg.1998;27:99-105.Google Scholar
25.
Rentschler  GJMann  MB The effects of glossectomy on intelligibility of speech and oral perceptual discrimination.  J Oral Surg.1980;38:348-354.Google Scholar
26.
Leonard  JLGillis  R Differential effects of speech prostheses in glossectomized patients.  J Prosthet Dent.1990;64:701-708.Google Scholar
27.
Pauloski  BRRademaker  AWLogemann  JAColangelo  LA Speech and swallowing in irradiated and nonirradiated postsurgical oral cancer patients.  Otolaryngol Head Neck Surg.1998;118:616-624.Google Scholar
28.
Michiwaki  YOhno  KImai  S  et al Functional effects of intraoral reconstruction with a free radial forearm flap.  J Craniomaxillofac Surg.1990;18:164-168.Google Scholar
29.
McConnel  FMPauloski  BRLogemann  JA  et al Functional results of primary closure vs flaps in oropharyngeal reconstruction: a prospective study of speech and swallowing.  Arch Otolaryngol Head Neck Surg.1998;124:625-630.Google Scholar
30.
Logemann  JAPauloski  BRRademaker  AW  et al Speech and swallow function after tonsil/base of tongue resection with primary closure.  J Speech Hear Res.1993;36:918-926.Google Scholar
31.
McConnel  FMLogemann  JARademaker  AW  et al Surgical variables affecting postoperative swallowing efficiency in oral cancer patients: a pilot study.  Laryngoscope.1994;104(1, pt 1):87-90.Google Scholar
Original Article
December 2002

Fasciocutaneous Flap Reconstruction of the Tongue and Floor of Mouth: Outcomes and Techniques

Author Affiliations

From the Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine, St Louis, Mo (Dr Haughey); the Division of Otolaryngology, Dalhousie University, Halifax, Nova Scotia (Dr Taylor); and St Louis University School of Communication Disorders, St Louis (Dr Fuller).

Arch Otolaryngol Head Neck Surg. 2002;128(12):1388-1395. doi:10.1001/archotol.128.12.1388
Abstract

Objectives  To quantify functional and other outcomes after major resection and fasciocutaneous free-flap reconstruction of the tongue and floor of mouth, and to describe reconstructive technique.

Design  A hypothesis-generating, retrospective cohort study of 43 patients who underwent, at minimum, a hemiglossectomy and resection of the floor of the mouth for oral cancer followed by fasciocutaneous free-flap reconstruction.

Setting  A tertiary academic medical center in the midwestern United States.

Main Outcome Measures  Speech intelligibility, swallowing, interval to decannulation, length of stay, free-flap success rates, patient survival, and complications.

Results  Thirty patients underwent oral tongue reconstructions, and 13, tongue base reconstructions. Median intelligibility scores were greater among patients in the tongue base group (98% intelligibility) than in the oral-tongue group (76% intelligibility) (P<.001). Of the 38 patients undergoing swallowing evaluation, 32 (85%) were able to feed entirely by mouth, most with mild to moderate dysphagia. All patients underwent decannulation (mean interval, 13.7 days). The mean length of hospital stay was 11 days, and free flaps in 42 patients (98%) survived. Twenty-eight patients (65%) were still alive by the end of the study, yielding a mean survival time of 27.4 months. Seven patients (16%) had severe medical and 3 (7%) had major surgical complications.

Conclusion  The folding techniques used in this study for reconstruction of the tongue with fasciocutaneous free flaps were associated with recovery of adequate speech and swallowing in most patients.

×