gms | German Medical Science

49. Jahrestagung der Österreichischen Gesellschaft für Plastische, Ästhetische und Rekonstruktive Chirurgie (ÖGPÄRC), 42. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen e. V. (DGPRÄC), 16. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen e. V. (VDÄPC)

29.09. - 01.10.2011, Innsbruck

A strategic approach for tongue reconstruction to achieve predictable and improved functional and aesthetic outcome

Meeting Abstract

  • author Holger Engel - BG-Unfallkinik Ludwigshafen
  • E. Gazyakan - Dep. of Hand, Plastic & Reconstructive Surgery;-Burn Center-, BG Trauma Center; Ruprecht-Karls University of Heidelberg, Ludwigshafen, Germany
  • J.J. Huang - Division of Reconstructive Microsurgery; Dep. of Plastic & Reconstructive Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan
  • C.Y. Lin - Division of Reconstructive Microsurgery; Dep. of Plastic & Reconstructive Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan
  • W. Lam - Division of Reconstructive Microsurgery; Dep. of Plastic & Reconstructive Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan
  • H.K. Kao - Division of Reconstructive Microsurgery; Dep. of Plastic & Reconstructive Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan
  • M.H. Cheng - Division of Reconstructive Microsurgery; Dep. of Plastic & Reconstructive Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan
  • M. Lehnhardt - Dep. of Hand, Plastic & Reconstructive Surgery;-Burn Center-, BG Trauma Center; Ruprecht-Karls University of Heidelberg, Ludwigshafen, Germany

Österreichische Gesellschaft für Plastische, Ästhetische und Rekonstruktive Chirurgie. Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen. Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen. 49. Jahrestagung der Österreichischen Gesellschaft für Plastische, Ästhetische und Rekonstruktive Chirurgie (ÖGPÄRC), 42. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 16. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC). Innsbruck, 29.09.-01.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11dgpraecV118

DOI: 10.3205/11dgpraec119, URN: urn:nbn:de:0183-11dgpraec1193

Veröffentlicht: 27. September 2011

© 2011 Engel et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: Free tissue transfer for tongue reconstruction has significantly improved reconstructive outcomes but there remains often, however, a lack of clear indications for the choice of each free flap in the literature, with many authors describing only one or two flaps for their entire series. We carried out a prospective study using a specially designed algorithm with different free flaps for different tongue defects to see if this strategic approach would lead to further improvements and more predictable outcomes for patients undergoing tongue reconstruction.

Materials and methods: Between 2000 and 2006, 104 patients underwent microsurgical tongue reconstruction using this protocol as follows: Group A: radial forearm flap for defects less than half (n= 42); Group B: anterolateral thigh (ALT) perforator flap for defects between half and two thirds (n=42); Group C: ALT myocutaenous flap for defects between two thirds and three quarters (n=7); and Group D: ALT myocutaenous flap with a pentagonal design for total glossectomy defects (n=13). The results were assessed in terms of swallowing, speech and cosmesis.

Results: Flap success was 98.1 %. 33 patients were available for follow-up at 15 months. Group A patients had a significantly better speech recovery than patients in Group D (p=0.04). In diet assessment, there was no significant difference in swallowing and chewing function between the different groups (p= 0.28). There was also no significant difference in the aesthetic results between groups A to D (p=0.76).

Conclusions: A strategic algorithm facilitates a clear, concise and problem-based approach in tongue reconstruction with improved and more predictable outcome