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Dynamic Hemitongue Defect Reconstruction With Functional Gracilis Muscle Free Transfer

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Abstract
Background

Because the tongue consists of 26 intrinsic and extrinsic muscles, even hemiglossectomy, which preserves some of the tongue and its muscles, leads to functional morbidity in speech and swallowing. Subsequent reconstruction using a conventional fasciocutaneous flap results in limited functional recovery. This study compared the functional recovery of patients who underwent hemiglossectomy based on the fasciocutaneous free flap with or without dynamic gracilis muscle flap reconstruction. Methods

Twenty-three patients were included in the study. Reconstruction was achieved using radial forearm and gracilis conjoined flaps (n = 7), gracilis flaps (n = 7), and radial forearm flaps (RFFFs) (n = 9) between 2014 and 2019. Functional outcome data were collected via videofluoroscopic swallowing, speech analysis, and a tongue movement scale. Results

In the conjoined flap group, the lingual range of motion in terms of elevation and defect-side lateralization was superior to that of the RFFF group. Furthermore, the conjoined flap was associated with superior protrusion, elevation, and lateralization (on both sides) than the gracilis-only flap. Patients who underwent conjoined-flap reconstruction had better articulation, intelligence, and dysphagia outcomes than patients who underwent reconstruction with RFFFs or gracilis-only flaps. Conclusions

Although this was a preliminary study, the findings suggest that using a conjoined free flap with an RFFF and a functional gracilis muscle flap for dynamic hemitongue reconstructions could improve postoperative tongue function.
Author(s)
박주석박호진정우식최종우
Issued Date
2021
Type
Article
Keyword
AnalysisForearm - surgeryFree Tissue FlapsGlossectomyGracilis MuscleHumansMedical collegesMedical researchExperimentalReconstructive Surgical ProceduresPlasticTongue Neoplasms - surgery
DOI
10.1097/SAP.0000000000002555
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7545
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2487429464&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Dynamic%20Hemitongue%20Defect%20Reconstruction%20With%20Functional%20Gracilis%20Muscle%20Free%20Transfer&offset=0&pcAvailability=true
Publisher
ANNALS OF PLASTIC SURGERY
Location
미국
Language
영어
ISSN
0148-7043
Citation Volume
86
Citation Number
3
Citation Start Page
308
Citation End Page
316
Appears in Collections:
Medicine > Medicine
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