Format

Send to

Choose Destination
See comment in PubMed Commons below
Otolaryngol Head Neck Surg. 2013 Oct;149(4):547-53. doi: 10.1177/0194599813498063. Epub 2013 Jul 24.

Flap selection and functional outcomes in total glossectomy with laryngeal preservation.

Author information

1
Departments of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Abstract

OBJECTIVE:

Reconstruction of total glossectomy defects has been revolutionized by the popularity of free flap use in the head and neck. Challenging defects can be addressed with a variety of different free and pedicled flaps. The purpose of this study is to review our method of flap selection in cases of total glossectomy defects with laryngeal preservation, with an emphasis on the variations of these defects and patient body habitus.

STUDY DESIGN:

Case series with chart review.

SETTING:

Tertiary care referral center.

SUBJECTS AND METHODS:

All patients undergoing total glossectomy with laryngeal preservation (TGLP) by the senior author (YD) from September 1997 to May 2012. Objective data regarding patient demographics, existing defect, method of reconstruction, adjuvant treatment, operative details, outcomes, and complications were recorded. Both means and frequency of prolonged tracheostomy or gastrostomy tube were used to assess outcomes.

RESULTS:

One hundred and three patients were identified. Ninety-four met inclusion criteria. All patients were T3 or T4 stage tumors. Mean follow-up was 3.4 years. Fifty-nine patients (62%) underwent free flap reconstruction while the remaining 35 (37%) were treated with a pedicled pectoralis myocutaneous flap. Tracheostomy decannulation and gastrostomy tube removal rates were 84% and 29%, respectively. No patients were converted to total laryngectomy.

CONCLUSION:

Optimal reconstruction of TGLP defects may be accomplished with either pedicled or free-tissue flap reconstruction. Selecting an ideal flap for reconstruction of total glossectomy defects should be patient specific and based on matching donor flap bulk. This treatment approach demonstrates high tracheostomy and gastric tube independence.

KEYWORDS:

free flap reconstruction; laryngeal preservation; oral cavity defect; oral cavity reconstruction; pectoralis muscle flap; tongue cancer; tongue defect; total glossectomy

PMID:
23884285
DOI:
10.1177/0194599813498063
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Atypon
    Loading ...
    Support Center