Tongue Reconstruction with Free Radial Forearm Flap After Hemiglossectomy: A Functional Assessment

Abstract

Thirty-three patients with squamous cell carcinoma of the anteriolateral part of the tongue underwent a 50 percent resection of the tongue. The surgical defect was reconstructed with a microvascular radial forearm flap. All the flaps were especially designed to have a narrow waist, shaped like an omega in cross-section, thus allowing for a free tongue tip, and avoiding suturing the edge of the flap to the soft palate and tongue base. Sixteen patients were evaluated for swallowing and speech function at least 6 months following reconstruction. With this technique, the majority of the patients had nearly normal deglutition, although their speech was still unsatisfactory. However, the speech function in this series was better than that in other reported series.

Functional assessment: Free thin anterolateral thigh flap versus free radial forearm reconstruction for hemiglossectomy defects

“…Among our serial patients, 34 patients underwent the reconstruction of hemiglossectomy defects with the FRF flap, and the results were acceptable. There are many advantages in reconstructing hemiglossectomy defects with the FRF flap: ( 1 ) easiness of harvest, ( 2 ) 2-team approach, ( 3 ) long pedicle, and ( 4 ) a thin and pliable skin paddle ( 15 ). However, it has some obvious disadvantages ( 16 , 17 ).…”

“…Furthermore, depending on the design of the flap needed, the thickness and the volume of the ALT flap can be adjusted for the individual extent of the defect ( 26 ). The appropriate flap bulk is also important in improving the tongue to palate contact, which is necessary for a bolus of food to descend into the hypopharynx ( 1 ). In our cases, 12 Among our patients underwent reconstruction of hemiglossectomy defects with the free thin ALT flap.…”

“…Most of them occur in the anterior two-thirds of the lateral border, followed by the tongue abdomen, the base of the tongue and the tip of tongue. In most of these cases, hemiglossectomy and immediate surgical reconstruction of tongue defects are performed ( 1 ). While carrying out the repair and reconstruction, it is necessary to rebuild the function and appearance of the tongue.…”

“…It is also important to reduce the damage of the donor site on both function and appearance ( 2 , 3 ). At present, free radial forearm (FRF) flap and free thin anterolateral thigh (ALT) flap are mainly used to reconstruct tongue defects, both of which has its own advantages and disadvantages ( 1 , 4 , 5 ).…”

Function-Preserving Neurotized Lateral Arm Free Flap in the Reconstruction of Hemiglossectomy Defects

“…LAFF has several advantages over radial forearm flap. 9 10 11 12 13 Most important being the expendable vascularity. The glabrous moderately thick flap with the prospectus for neurotization and the ease of harvest without the need of change in position makes it a flap of choice in head and neck reconstruction.…”