Tongue Reconstruction: Algorithm Approach Free Flaps for Optimizing Speech and Swallow On Defect Size

The aim of the present study is to assess functional outcomes after excision of the tumor tongue and microvascular reconstruction on defect size.

Materials and methods: study of cases reconstruction of oropharyngeal zone defects after radical operations for cancer from 2015 to 2018 in our department. N=31 patients. Age was 43.3 ± 16 years. Primary tumors were noticed in 28% of patients, recurrence tumors in 39%, and 33% of patients underwented preoperative neoadjuvant treatment. We used flaps for reconstruction of post-resection defects: RF flap with sensor innervated -14, chimeric thoracodorsal flap LD+SA with motor innervated – 11, visceral flap -2, thoracodorsal flap -2, ALT flap-1

Results: Mean follow-up was 26 months. Reconstruction was successfully completed in 94.4% of patients. 88.9% of patients were free air. 26 (86%) patients were able to feed entirely by mouth. Speech function was completely restored in 82% of patients. A study of the degree of atrophy of the reinervated flaps showed that during the first two months after the operation, the volume decreased by 15% from the initial, by the 6th month the stabilization occurred and the size of the flap remained unchanged during the subsequent observation period.

Conclusions: Tongue cancer resection and subsequent reconstruction pose interesting challenges to the surgeon to maximize postoperative function and quality of life. Attention to the principles of tongue reconstruction and knowledge of the range of available reconstructive options can result in more favorable functional outcomes.