Total Glossectomy With Free Flap Reconstruction: Twenty‐Year Experience at a Tertiary Medical Center

Abstract

Objectives/Hypothesis To characterize the demographics, clinicopathologic characteristics, and treatment and reconstructive outcomes of patients who underwent total glossectomy Study Design Retrospective chart review at an academic tertiary‐care medical center. Methods All patients who had undergone total glossectomy (as an individual procedure or as part of a more extensive resection) between January 1, 1995 and December 31, 2014 were included in the analysis. Patient characteristics and clinical outcomes were reviewed. Results Forty‐eight patients underwent total glossectomy for oral tongue and base of tongue cancer. The mean age of the patients was 56 (range, 29–92 years). History of tobacco and heavy alcohol use was found in 76% and 11% of patients, respectively. The majority of patients had advanced cancer (91.7% at stage IV), and 60.4% had salvage therapy for recurrent disease. T4 disease comprised 81% of patients. Sixty percent had clinical or radiographic evidence of nodal metastasis. Reconstruction of the defect was performed with free flaps from the rectus abdominus (40%), fibula (25%), anterolateral thigh (23%), and other donor tissues. One‐ and 5‐year survival rates were 42% and 26%, with locoregional and distant recurrence reported at 36% and 25%, respectively. Conclusions Total glossectomy for oncologic control is most commonly performed in patients who have stage IV cancers. Despite high reconstructive success rates, the likelihood of locoregional and distance recurrence was high. Most patients can communicate intelligibly and achieve decannulation, but swallowing outcomes remain guarded, especially considering previous irradiation and resection of the base of tongue. Level of Evidence 4 Laryngoscope, 129:1087–1092, 2019

Advances in oral tongue reconstruction: a reconstructive paradigm and review of functional outcomes

“…The anterolateral thigh (ALT) free flap has become a commonly utilized reconstructive option for near total and total glossectomy defects over alternative flaps including the rectus abdominis flap [19].…”

Comparison of Treatment Outcomes Between Total and Near Total Glossectomy With Larynx Preservation and Flap Reconstruction: A Single Institution Experience With 23 Patients

“…Total laryngectomy (TL) combined with TG is suggested in conventional teaching to overcome aspiration problems. With the emergence of successful reconstruction techniques with flaps, some studies have reported promising functional results by preserving the larynx ( 1 , 5 , 6 , 7 ). They suggested that total glossectomy with laryngeal preservation (TGLP) provided better speech intelligibility and maintained swallowing ability ( 6 , 7 , 8 , 9 , 10 , 11 ).…”

Chimeric profunda artery perforator ‐ gracilis flap: A computed tomographic angiography study and case report

“…Microsurgical reconstruction is preferred for large tongue defects. Bulky flaps assuring palatal‐glossal contact, such as the rectus abdominus (RA) and the anterolateral (ALT) free flaps, are among the most popular reconstructive options worldwide (Chepeha, 2010; Han et al, 2019). Recently, the profunda artery perforator (PAP) flap, harvested from the posteromedial region of the thigh, has been proposed as a good choice for tongue reconstruction (Fernández‐Riera et al, 2017; Heredero et al, 2019; Scaglioni et al, 2015; Wu et al, 2016).…”