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Secondary microvascular tongue reconstruction: Functional results
Author(s) -
Salibian Arthur H.,
Allison Glenn R.,
Strelzow Victor V.,
Krugman Mark E.,
Rappaport Irving,
McMicken Betty L.,
Etchepare Terry L.,
Sultan Mark R.
Publication year - 1993
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.2880150505
Subject(s) - tongue , medicine , swallowing , floor of mouth , dentistry , surgery , pathology
Between 1978 and 1991, 56 microvascular composite flaps were used for oromandibular reconstructions: 15 for primary total and subtotal tongue reconstruction and five for secondary major tongue reconstruction. The delayed reconstructions were performed to improve the oral and pharyngeal phases of swallowing. Using a floor of the mouth composite bone grafting technique to reposition the tongue and obliterate the oral dead space intraoral food transport was improved (three of five patients), but aspiration persisted (three of four patients). When compared with 10 patients evaluated for primary total and subtotal tongue reconstruction the primary reconstruction group showed superior swallowing (eight dynamic oral transport, no aspiration) and speech results. The poor results of secondary reconstruction are attributed to scarring and irreversible damage to remaining functional muscles involved in protecting the laryngeal aditus.