[Total glossectomy with larynx preservation and reconstruction with rectus abdominis free flap].
OBJECTIVE
Our objective was to show the complexity and series of events needed to perform the reconstruction with rectus abdominis free flap to achieve an adequate rehabilitation for patients submitted to total glossectomy with larynx preservation due to advanced tongue carcinoma.


METHODS
Two patients with stage IV carcinoma of the tongue were treated with surgery--one as primary treatment, the other for recurrence. Patients underwent total glossectomy, bilateral radical neck dissection, gastrostomy, tracheostomy, and reconstruction with rectus abdominis free flap.


RESULTS
Both patients had an uneventful postoperative evolution and were discharged from the hospital without tracheostomy on the 7th and 8th days, respectively. The patient who received primary treatment is currently receiving adjuvant radiotherapy.


CONCLUSIONS
Patients requiring total glossectomy, either with or without laryngectomy, must undergo a careful and individualized selection of the reconstructive procedure by a highly specialized surgical team. The rectus abdominis flap represents one of the best options for reconstruction in patients treated with total glossectomy. Its main disadvantage is seen in overweight patients, in whom the flap volume taken may be excessive for the oral cavity. Most of these patients are fed by a gastrostomy tube, which may be removed only when aspiration is absent. The type of gastrostomy can even be evaluated before surgery.
Luna-Ortiz
Kuauhyama
K
Departamento de Cabeza y Cuello, Instituto Nacional de Cancerología, San Fernando 22, Tlalpan, 14080 Mexico DF. kuauhyama@starmedia.com
Rascón-Ortiz
Mario
M
Granados-García
Martín
M
Rojas-Calvillo
Antonio
A
Herrera-Gómez
Angel
A
D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005927:Glossectomy / Q000379:methods*; D006801:Humans; D007830:Larynx / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D017568:Rectus Abdominis / Q000601:surgery; D013524:Surgical Flaps; D014062:Tongue Neoplasms / Q000601:surgery*; D016896:Treatment Outcome