A new flap design for tongue reconstruction after total or subtotal glossectomy in thin patients

Sakuraba, Minoru; Asano, Takayuki; Miyamoto, Shimpei; Hayashi, Ryuichi; Yamazaki, Mitsuo; Miyazaki, Masakazu; Ugumori, Toru; Daiko, Hiroyuki; Kimata, Yoshihiro

doi:10.1016/j.bjps.2007.09.056

Cited by 45 publications

(51 citation statements)

References 10 publications

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“…Yun et al [6] stated that even though neotongue volume declined with the passage of time, the tongue maintained a protuberant shape until 3 years postoperative, and all subjects in their study could eat soft foods and communicate by speaking. However, even within 1 or 3 months after Xap reconstruction, deWnitive volume change may occur according to body type (thin or obese) or age; therefore, a period of 2 years may be suYcient for observing and measuring reconstructed Xap volume changes [9,10]. However, a future investigation with a longer observation period and larger number of patients is needed to obtain a more deWnitive result for suggesting guidelines for volume overcorrection of the Xap.…”

Section: Discussionmentioning

confidence: 96%

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Perioperative clinical factors affecting volume changes of reconstructed flaps in head and neck cancer patients: free versus regional flaps

Cho

Joo

Sun

et al. 2010

Eur Arch Otorhinolaryngol

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Postoperative volume changes in reconstructed flaps are known to influence the functional restoration of resected areas of the upper aerodigestive tract. The purposes of this study were to estimate the volume decreases in flaps and investigate clinical factors affecting the volume decrease. The medical records of 19 patients who underwent ablation and flap reconstruction surgeries for head and neck cancers were reviewed. The volume of the reconstructed flap was measured at 3, 12, and 24 months postoperatively using CT or MR imaging and the 3D-DOCTOR software. The relationships between volume changes and perioperative clinical parameters were examined. The primary tumor locations were the nasal cavity and paranasal sinus, oropharynx, oral cavity, and hypopharynx in 8, 6, 4, and 1 case, respectively. Twelve patients underwent anterolateral thigh flap (ALTF) reconstruction, and seven patients underwent pectoralis major myocutaneous flap (PMMCF) reconstruction. Twelve (63.2%) patients received postoperative radiation. The estimated volume decreases at 12 and 24 months postoperatively for ALTF were 20.9 and 24.8%, respectively, while those for PMMCF were 7.3 and 10.8%, respectively. Among clinical factors, only the type of flap affected the volume change. When determining the volume of reconstructed flaps, the type of flap must be considered. It was recommended to make free and regional flaps at least 20 and 10% larger, respectively than the actual defect.

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Section: Discussionmentioning

confidence: 96%

“…A protuberant shape and suYcient volume are known to be the most important factors in obtaining satisfactory oral function when reconstructing a tongue [9].…”

Section: Discussionmentioning

confidence: 99%

Perioperative clinical factors affecting volume changes of reconstructed flaps in head and neck cancer patients: free versus regional flaps

Cho

Joo

Sun

et al. 2010

Eur Arch Otorhinolaryngol

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“…In these cases, Sakuraba et al 12 suggested widening the flap design and inserting a de-epithelialized portion of the skin paddle under the flap to increase flap volume.…”

Section: Discussionmentioning

confidence: 98%

“…7 Microsurgical free flaps allow transfer of a greater volume of tissue, promoting functional rehabilitation after tongue reconstruction. The most commonly used choices in this setting are the rectus abdominis flaps 6,[9][10][11][12] and the ALT perforator flaps. 13 Table 4 shows findings from several authors concerning the functional results and the type of reconstruction after total or subtotal glossectomy.…”

Section: Discussionmentioning

confidence: 99%

Total or subtotal glossectomy with microsurgical reconstruction: Functional and oncological results

et al. 2011

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“…Adequate volume of the microvascular flap inserted into the head and neck defects is known to be the most important factor in obtaining satisfactory oral function and aesthetic outcomes when reconstructing the defect after advanced tumor resection [13,14]. Most surgeons in the reconstruction field usually anticipate some postoperative autologous volume loss of the flap [15,16].…”

Section: Discussionmentioning

confidence: 99%

Factors to Consider When Deciding on the Type of Free-Flap Reconstruction of Head and Neck Soft Tissue Defects

Aladimi

Han

et al. 2017

ORL

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Objectives: The aim of the study was to evaluate the functional and aesthetic outcomes on donor and recipient sites and to determine the effects of technical factors including flap thickness and vessel diameters measured by ultrasonography as well as the size of the defect and postoperative volume reduction of the flaps measured by magnetic resonance imaging (MRI). Methods: In patients who had undergone soft tissue reconstructive surgery between March 2013 and March 2016 using 55 anterolateral thigh flaps (ALTFs), 30 radial forearm flaps (RFFs), and 18 latissimus dorsi flaps (LDFs), color Doppler ultrasonography was performed to measure the thickness of the flap at the site of the perforator. Preoperative color Doppler ultrasound examinations of the blood vessel diameters of donor and recipient sites were carried out. Results: 97.1% of flaps showed complete survival and 2.9% complete failure (2 ALTFs and 1 LDF). The difference in flap volume of ALTFs, RFFs, and LDFs between MRI 1 (3-6 weeks) and MRI 2 (6-18 months) was 27.6, 17.9, and 36.1%, respectively. Conclusion: Proper selection of the flap is important for the optimization of the aesthetic and functional outcomes. Ultrasound, the surgeon's experience and the extension and nature of the defect play a key role in the selection of the flap.

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A new flap design for tongue reconstruction after total or subtotal glossectomy in thin patients

Cited by 45 publications

References 10 publications

Perioperative clinical factors affecting volume changes of reconstructed flaps in head and neck cancer patients: free versus regional flaps

Perioperative clinical factors affecting volume changes of reconstructed flaps in head and neck cancer patients: free versus regional flaps

Total or subtotal glossectomy with microsurgical reconstruction: Functional and oncological results

Factors to Consider When Deciding on the Type of Free-Flap Reconstruction of Head and Neck Soft Tissue Defects

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