Arch Craniofac Surg.  2019 Mar;20(1):37-43. 10.7181/acfs.2018.02005.

Exclusive tongue tip reconstruction of hemiglossectomy defects using the underrated lateral arm free flap with bilobed design

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Hanyang University Seoul Hospital, Hanyang University College of Medicine, Seoul, Korea. ahnhc@hanyang.ac.kr
  • 2Department of Plastic and Reconstructive Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
  • 3Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
Tongue reconstruction is challenging with the unique function and anatomy. Goals for reconstruction differ depending on the extent of reconstruction. Thin and pliable flaps are useful for tongue tip reconstruction, for appearance and mobility. This study reports lateral arm free flap (LAFF) as a safe and optimal option for hemi-tongue reconstruction, especially for tongue tip after hemiglossectomy.
METHODS
Thirteen LAFFs were performed for hemi-tongue reconstruction after hemiglossectomy from 1995 to 2018. Of the 13 patients, seven were male and six were female, age varying from 24 to 64 years.
RESULTS
All flaps healed uneventfully without complications. Donor sites were closed primarily. The recipient vessels for microvascular anastomosis were mainly superior thyroidal artery, external jugular vein. All patients returned to normal diet, with no complaints regarding reconstructed tongue and donor site.
CONCLUSION
The LAFF is hairless, thin (especially with lateral epicondyle approach), and potentially sensate. They are advantageous features for tongue tip and hemi-tongue reconstruction. Donor site sacrifices the inessential posterior radial collateral artery, and the scar is hidden under short sleeve shirts. We believe that LAFF can be considered as the first choice flap for hemitongue reconstruction, over radial forearm free flaps.

Keyword

Neoplasms; Reconstructive surgical procedures; Surgical flaps

MeSH Terms

Arm*
Arteries
Cicatrix
Diet
Female
Forearm
Free Tissue Flaps*
Humans
Jugular Veins
Male
Reconstructive Surgical Procedures
Surgical Flaps
Thyroid Gland
Tissue Donors
Tongue*
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