Functional reconstruction of near total glossectomy defects using composite gastro omental-dynamic gracilis flaps

Sharma, Mohit; Iyer, Subramania; Kuriakose, Moni Abraham; Vijayaraghavan, Sundeep; Arun, P.; Sudhir, Vinod; Chatni, Shilpa; Sharan, Rajeev

doi:10.1016/j.bjps.2007.10.092

Cited by 24 publications

(16 citation statements)

References 9 publications

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“…We did not perform any type of dynamic tongue reanimation, nor did we make use of gastro‐omental free flap along with free gracilis muscle flap, although these have been reported to be suitable for achieving functional dynamic tongue reconstruction …”

Section: Methodsmentioning

confidence: 99%

Classification of tongue cancer resection and treatment algorithm

Mannelli

Arcuri

Agostini

et al. 2018

Journal of Surgical Oncology

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Section: Methodsmentioning

confidence: 99%

Classification of tongue cancer resection and treatment algorithm

Mannelli

Arcuri

Agostini

et al. 2018

Journal of Surgical Oncology

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“…This procedure although providing adequate glossopalatal contact and tongue movements, still does not achieve normal tongue appearance and has no intrinsic secretory capability. To circumvent this problem, in addition to the gracilis muscle flap, a free stomach flap, with mucosal surface intraorally, has been used as an added source of secretion for dry mouth with attached omentum providing adequate bulk [96]. …”

Section: Reconstruction Of Extensive Defectsmentioning

confidence: 99%

Contemporary management of cancer of the oral cavity

Genden

Ferlito²,

Silver

et al. 2010

Eur Arch Otorhinolaryngol

116

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Oral cancer represents a common entity comprising a third of all head and neck malignant tumors. The options for curative treatment of oral cavity cancer have not changed significantly in the last three decades; however, the work up, the approach to surveillance, and the options for reconstruction have evolved significantly. Because of the profound functional and cosmetic importance of the oral cavity, management of oral cavity cancers requires a thorough understanding of disease progression, approaches to management and options for reconstruction. The purpose of this review is to discuss the most current management options for oral cavity cancers.

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“…The IGMF was first described by Yousif et al in 1999, emphasizing that active contraction of the muscle can elevate the posterior pharynx, miming the suction bump of the pharyngeal swallowing phase, and providing a sufficient bulk in addition to offering a reliable and easily accessible donor site . Moreover, Sharma et al highlighted three other major advantages of the gracilis muscle: it elevates the larynx, matches the correct tongue size, and can actively move in a coordinated way for swallowing and speech . To the best of our knowledge, the gracilis muscle shares an important characteristic with the tongue muscles (i.e., hyoglossus and genioglossus).…”

Section: Discussionmentioning

confidence: 99%

“…For example, in 1999 Lyos et al chose the rectus abdominis free flap (RAFF) for its exceptional abundance of tissue, 6 but with the sole purpose of filling the oral cavity and allowing glossopalatal contact. 13 However, the main aim of the techniques currently employed, such as the LDM flap, 4 RFFF, ALT flap, 5 and innervated RAFF, is to acquire some degree of active movement. 5 For this purpose, the motor innervation of the muscle of the neotongue must be restored with microsurgical anastomosis between the flap's nerve and the hypoglossal nerve.…”

Section: Discussionmentioning

confidence: 99%

“…7 Moreover, Sharma et al highlighted three other major advantages of the gracilis muscle: it elevates the larynx, matches the correct tongue size, and can actively move in a coordinated way for swallowing and speech. 13 To the best of our knowledge, the gracilis muscle shares an important characteristic with the tongue muscles (i.e., hyoglossus and genioglossus). During contraction, it undergoes a great change of length from full extension to full shortening.…”

Section: Discussionmentioning

confidence: 99%

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Dynamic tongue reconstruction with innervated gracilis musculocutaneos flap after total glossectomy

et al. 2018

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Objective Advanced tongue cancer treated with total glossectomy with laryngeal preservation (TGLP) has a high risk of severe postoperative morbidity due to the loss of swallowing and articulation ability. The purpose of our work is to highlight the potential of the innervated gracilis musculocutaneous flap (IGMF) to permit a good quality of life in patients after undergoing this kind of surgery, particularly when associated with an adequate rehabilitation course. Methods We are presenting a cohort of 15 patients with T3 or T4 tongue cancer treated with TGLP and dynamic reconstruction with IGMF between 1998 and 2016. Functional outcome data were collected employing flexible endoscopic examination of swallowing, as well as swallowing and speech tests and questionnaires. Our reconstructive procedure was compared with different techniques described in the literature. Results In 13 out of 15 patients, a positive functional outcome was recorded, defined as the achievement of an adequate swallowing and speech ability. In two patients, the lack of success was caused by the flap's necrosis and death from early pulmonary metastasis. Of 13 patients, 12 were still alive after 2 years. Ten patients regained an independent feeding by mouth for normal food, whereas three patients continued percutaneous endoscopic gastrotomy supplementation. After 40 months, all 13 patients displayed a moderately intelligible speech capability. Conclusion Although TGLP can have devastating morbid effects, an appropriate dynamic reconstruction—along with an adequate course of rehabilitation—can provide good swallowing and articulation outcomes, which permit a satisfactory long‐term quality of life. Level of Evidence 4 Laryngoscope, 129:76–81, 2019

show abstract

Functional reconstruction of near total glossectomy defects using composite gastro omental-dynamic gracilis flaps

Cited by 24 publications

References 9 publications

Classification of tongue cancer resection and treatment algorithm

Classification of tongue cancer resection and treatment algorithm

Contemporary management of cancer of the oral cavity

Dynamic tongue reconstruction with innervated gracilis musculocutaneos flap after total glossectomy

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