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Invited commentary| Volume 65, ISSUE 7, e169-e174, July 2012

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Modification of flap design for total mobile tongue reconstruction using a sensitive antero-lateral thigh flap

Published:December 06, 2011DOI:https://doi.org/10.1016/j.bjps.2011.11.012

      Summary

      Reconstruction of large carcinologic tongue defect is mandatory to recover adequate speech and swallowing. Free flaps provide thin and pliable tissues needed to restore the shape and the volume of the tongue but their functional outcomes, especially in case of total mobile tongue reconstruction, are still limited. The authors describe a modification of flap design called the ‘cathedral triptych’ used with the antero-lateral thigh flap. This modified design recreates a near normal neotongue shape with more projected tip and vertical bulk that can contact the palate and the upper lip. Ten patients underwent total mobile tongue reconstruction with a sensitive antero-lateral thigh flap and a ‘cathedral triptych’ design. This modification of flap shaping and folding optimises postoperative oral function.

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      References

        • Urken M.L.
        • Moscoso J.F.
        • Lawson W.
        • Biller H.F.
        A systematic approach to functional reconstruction of the oral cavity following partial and total glossectomy.
        Arch Otolaryngol Head Neck Surg. 1994; 120: 589-601
        • Soutar D.S.
        • Scheker L.R.
        • Tanner N.S.
        • McGregor I.A.
        The radial forearm flap: a versatile method for intra-oral reconstruction.
        Br J Plast Surg. 1983; 36: 1-8
        • Salibian A.H.
        • Allison G.R.
        • Armstrong W.B.
        • et al.
        Functional hemitongue reconstruction with the microvascular ulnar forearm flap.
        Plast Reconstr Surg. 1999; 104: 654-660
        • Haughey B.H.
        Tongue reconstruction: concepts and practice.
        Laryngoscope. 1993; 103: 1132-1141
        • Urken M.L.
        • Biller H.F.
        A new bilobed design for the sensate radial forearm flap to preserve tongue mobility following significant glossectomy.
        Arch Otolaryngol Head Neck Surg. 1994; 120: 26-31
        • Haughey B.H.
        • Taylor S.M.
        • Fuller D.
        Fasciocutaneous flap reconstruction of the tongue and floor of mouth: outcomes and techniques.
        Arch Otolaryngol Head Neck Surg. 2002; 128: 1388-1395
        • Sultan M.R.
        • Coleman 3rd, J.J.
        Oncologic and functional considerations of total glossectomy.
        Am J Surg. 1989; 158: 297-302
        • Nakajima H.
        • Fujino T.
        • Adachi S.
        A new concept of vascular supply to the skin and classification of skin flaps according to their vascularization.
        Ann Plast Surg. 1986; 16: 1-19
        • Koshima I.
        • Fukuda H.
        • Yamamoto H.
        • Moriguchi T.
        • Soeda S.
        • Ohta S.
        Free anterolateral thigh flaps for reconstruction of head and neck defects.
        Plast Reconstr Surg. 1993; 92 (discussion 9–30): 421-428
        • Kimura N.
        • Satoh K.
        Consideration of a thin flap as an entity and clinical applications of the thin anterolateral thigh flap.
        Plast Reconstr Surg. 1996; 97: 985-992
        • Chana J.S.
        • Wei F.C.
        A review of the advantages of the anterolateral thigh flap in head and neck reconstruction.
        Br J Plast Surg. 2004; 57: 603-609
        • Wei F.C.
        • Jain V.
        • Celik N.
        • Chen H.C.
        • Chuang D.C.
        • Lin C.H.
        Have we found an ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps.
        Plast Reconstr Surg. 2002; 109 (discussion 27–30): 2219-2226