Continuous En Bloc Excision Of Carcinoma Of The Tongue With Vascular (Myocutaneous) Flap Reconstruction: A Functional Study After Surgery

Objectives To patients who had continuous en bloc excision of tumor, floor of mouth, neck lymph nodes, compare their speech, mastication and flap atrophy rate after reconstructed with anterolateral thigh cutaneous flap or forearm flap, so as to explore the indications of the flaps.Methods From 2006-2007, 47 patients who underwent surgery in Xiangya Second Hospital and Hunan Oncology Hospital due to carcinoma of tongue. 3-18 months after the surgery, measure and compare their speech, mastication, food residue, tongue mandibular groove and flap atrophy ratio between different groups.Rresults1. Patients reconstructed with anterolateral thigh cutaneous flap has smaller tongue mandibular groove, less food residue, lower flap atrophy rate, better mastication but poor speech.2. Mastication shows no difference between mandibular split and non-split groups.3. Radiotherapy group has higher flap atrophy rate, poor speech and mastication.Conclusions1. Precise mandibular split with rigid internal fixation does no harm to mastication.2. Anterolateral thigh cutaneous flap reconstruction is beneficial to mastication of patients after surgery, but shows no superiority in speech.3. Radiotherapy would speed flap atrophy, worsen speech and mastication.