Free-Flap Reconstruction of the Tongue

Abstract

The tongue is paramount to natural speech and swallowing, and good tongue function is important in the overall quality of life. Autologous free-flap reconstruction of the tongue after glossectomy allows for adequate speech, swallow, and quality-of-life outcomes in a majority of patients. Herein, the authors review autologous free-flap reconstruction of the tongue with a focus on different flap options, speech and swallow outcomes, quality-of-life outcomes, and factors that affect how patients perform after tongue reconstruction.

Keywords

tongue reconstruction - free tissue transfer - head and neck cancer

• References

• 1 de Vicente JC, de Villalaín L, Torre A, Peña I. Microvascular free tissue transfer for tongue reconstruction after hemiglossectomy: a functional assessment of radial forearm versus anterolateral thigh flap. J Oral Maxillofac Surg 2008; 66 (11) 2270-2275
• 2 Lam L, Samman N. Speech and swallowing following tongue cancer surgery and free flap reconstruction--a systematic review. Oral Oncol 2013; 49 (06) 507-524
• 3 Hartl DM, Dauchy S, Escande C, Bretagne E, Janot F, Kolb F. Quality of life after free-flap tongue reconstruction. J Laryngol Otol 2009; 123 (05) 550-554
• 4 Bokhari WA, Wang SJ. Tongue reconstruction: recent advances. Curr Opin Otolaryngol Head Neck Surg 2007; 15 (04) 202-207
• 5 Nicoletti G, Soutar DS, Jackson MS, Wrench AA, Robertson G. Chewing and swallowing after surgical treatment for oral cancer: functional evaluation in 196 selected cases. Plast Reconstr Surg 2004; 114 (02) 329-338
• 6 Diz Dios P, Fernández Feijoo J, Castro Ferreiro M, Alvarez Alvarez J. Functional consequences of partial glossectomy. J Oral Maxillofac Surg 1994; 52 (01) 12-14
• 7 Hara I, Gellrich NC, Düker J. , et al. Evaluation of swallowing function after intraoral soft tissue reconstruction with microvascular free flaps. Int J Oral Maxillofac Surg 2003; 32 (06) 593-599
• 8 Hanna TC, Lubek JE. The hybrid submental flap for tongue reconstruction. J Oral Maxillofac Surg 2015; 73 (09) 1876.e1-1876.e6
• 9 Baas M, Duraku LS, Corten EML, Mureau MAM. A systematic review on the sensory reinnervation of free flaps for tongue reconstruction: does improved sensibility imply functional benefits?. J Plast Reconstr Aesthet Surg 2015; 68 (08) 1025-1035
• 10 Chien CY, Su CY, Hwang CF, Chuang HC, Jeng SF, Chen YC. Ablation of advanced tongue or base of tongue cancer and reconstruction with free flap: functional outcomes. Eur J Surg Oncol 2006; 32 (03) 353-357
• 11 Liao G, Su Y, Zhang J, Hou J, Chen Y, Li M. Reconstruction of the tongue with reinnervated rectus abdominis musculoperitoneal flaps after hemiglossectomy. J Laryngol Otol 2006; 120 (03) 205-213
• 12 Biglioli F, Liviero F, Frigerio A, Rezzonico A, Brusati R. Function of the sensate free forearm flap after partial glossectomy. J Craniomaxillofac Surg 2006; 34 (06) 332-339
• 13 Yu P, Robb GL. Reconstruction for total and near-total glossectomy defects. Clin Plast Surg 2005; 32 (03) 411-419 , vii
• 14 Yu P. Reinnervated anterolateral thigh flap for tongue reconstruction. Head Neck 2004; 26 (12) 1038-1044
• 15 Longo B, Pagnoni M, Ferri G, Morello R, Santanelli F. The mushroom-shaped anterolateral thigh perforator flap for subtotal tongue reconstruction. Plast Reconstr Surg 2013; 132 (03) 656-665
• 16 Chang EI, Yu P, Skoracki RJ, Liu J, Hanasono MM. Comprehensive analysis of functional outcomes and survival after microvascular reconstruction of glossectomy defects. Ann Surg Oncol 2015; 22 (09) 3061-3069
• 17 Ozkan O, Ozkan O, Derin AT. , et al. True functional reconstruction of total or subtotal glossectomy defects using a chimeric anterolateral thigh flap with both sensorial and motor innervation. Ann Plast Surg 2015; 74 (05) 557-564
• 18 Yoleri L, Mavioğlu H. Total tongue reconstruction with free functional gracilis muscle transplantation: a technical note and review of the literature. Ann Plast Surg 2000; 45 (02) 181-186
• 19 Manrique OJ, Leland HA, Langevin CJ. , et al. Optimizing outcomes following total and subtotal tongue reconstruction: a systematic review of the contemporary literature. J Reconstr Microsurg 2017; 33 (02) 103-111
• 20 Dziegielewski PT, Ho ML, Rieger J. , et al. Total glossectomy with laryngeal preservation and free flap reconstruction: objective functional outcomes and systematic review of the literature. Laryngoscope 2013; 123 (01) 140-145
• 21 Matsui Y, Shirota T, Yamashita Y, Ohno K. Analyses of speech intelligibility in patients after glossectomy and reconstruction with fasciocutaneous/myocutaneous flaps. Int J Oral Maxillofac Surg 2009; 38 (04) 339-345
• 22 Shin YS, Koh YW, Kim SH. , et al. Radiotherapy deteriorates postoperative functional outcome after partial glossectomy with free flap reconstruction. J Oral Maxillofac Surg 2012; 70 (01) 216-220
• 23 Brown L, Rieger JM, Harris J, Seikaly H. A longitudinal study of functional outcomes after surgical resection and microvascular reconstruction for oral cancer: tongue mobility and swallowing function. J Oral Maxillofac Surg 2010; 68 (11) 2690-2700
• 24 Namin AW, Varvares MA. Functional outcomes of sensate versus insensate free flap reconstruction in oral and oropharyngeal reconstruction: a systematic review. Head Neck 2016; 38 (11) 1717-1721
• 25 Pedersen A, Wilson J, McColl E, Carding P, Patterson J. Swallowing outcome measures in head and neck cancer--how do they compare?. Oral Oncol 2016; 52: 104-108
• 26 Chen AY, Frankowski R, Bishop-Leone J. , et al. The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M. D. Anderson dysphagia inventory. Arch Otolaryngol Head Neck Surg 2001; 127 (07) 870-876
• 27 Rihani J, Lee T, Ducic Y. Secondary onlay free flap reconstruction of glossectomy defects following initial successful flap restoration. Otolaryngol Head Neck Surg 2013; 149 (02) 232-234