title: Secondary onlay free flap reconstruction of glossectomy defects following initial successful flap restoration.
abstract: Patients who undergo tongue reconstruction over time may develop gradual worsening of dysarthria and dysphagia secondary to flap atrophy. At our institution, these patients undergo a secondary flap onlay procedure for augmentation of the neotongue. We review a total of 11 patients with total glossectomy defect who underwent secondary tongue augmentation with secondary onlay free flap consisting of radial forearm free flap (n = 6) and rectus free flap (n = 5). There was improvement in swallowing in 7 of 11 patients. Five (45.4%) patients achieved gastric tube independence. Seven (63.6%) patients achieved a varying degree of oral intake. All patients achieved tracheostomy independence. Dysarthria was improved in all patients. There were no flap failures. Therefore, a secondary onlay flap technique is feasible and may improve dysphagia and dysarthria to achieve gastric tube and tracheostomy independence in total glossectomy patients with delayed tongue atrophy.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Jordan
authors.initials: J
authors.lastname: Rihani
authors.forename: Thomas
authors.initials: T
authors.lastname: Lee
authors.forename: Yadranko
authors.initials: Y
authors.lastname: Ducic
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D003679:Deglutition; D005260:Female; D005542:Forearm / Q000601:surgery; D058752:Free Tissue Flaps; D005927:Glossectomy; D006801:Humans; D007284:Inlays; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012086:Reoperation; D014059:Tongue / Q000502:physiology / Q000601:surgery*; D014062:Tongue Neoplasms / Q000601:surgery*; D016896:Treatment Outcome
keywords: double free flap; dysphagia; laryngeal preservation; oral cavity defect; oral cavity reconstruction; oral function; tongue cancer; tongue defect; tongue reconstruction; total glossectomy