대한두개안면성형외과학회지 (Archives of Craniofacial Surgery)

  • 제20권1호
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  • Pages.37-43
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  • 2019
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  • 2287-1152(pISSN)
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  • 2287-5603(eISSN)
대한두개안면성형외과학회 (Korean Cleft Palate-Craniofacial Association)
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Exclusive tongue tip reconstruction of hemiglossectomy defects using the underrated lateral arm free flap with bilobed design

  • Oh, Jeongseok (Department of Plastic and Reconstructive Surgery, Hanyang University Seoul Hospital, Hanyang University College of Medicine) ;
  • Lee, Tae Hyeon (Department of Plastic and Reconstructive Surgery, Hanyang University Seoul Hospital, Hanyang University College of Medicine) ;
  • Lee, Jang Hyun (Department of Plastic and Reconstructive Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Tae, Kyung (Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine) ;
  • Park, Seong Oh (Department of Plastic and Reconstructive Surgery, Hanyang University Seoul Hospital, Hanyang University College of Medicine) ;
  • Ahn, Hee Chang (Department of Plastic and Reconstructive Surgery, Hanyang University Seoul Hospital, Hanyang University College of Medicine)
  • 투고 : 2018.07.05
  • 심사 : 2018.11.02
  • 발행 : 2019.02.20
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초록

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.

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참고문헌

  1. Ganly I, Goldstein D, Carlson DL, Patel SG, O'Sullivan B, Lee N, et al. Long-term regional control and survival in patients with "low-risk," early stage oral tongue cancer managed by partial glossectomy and neck dissection without postoperative radiation: the importance of tumor thickness. Cancer 2013;119: 1168-76. https://doi.org/10.1002/cncr.27872
  2. Liu J, Wu H, Zhu Z, Wu X, Tan H, Wang K. Free anterolateral thigh myocutaneous flap for reconstruction of soft tissue defects following en block resection of tongue cancer. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2010;24:82-6.
  3. Tesseroli MA, Calabrese L, Carvalho AL, Kowalski LP, Chiesa F. Discontinuous vs. in-continuity neck dissection in carcinoma of the oral cavity: experience of two oncologic hospitals. Acta Otorhinolaryngol Ital 2006;26:350-5.
  4. Baas M, Duraku LS, Corten EM, Mureau MA. A systematic review on the sensory reinnervation of free flaps for tongue reconstruction: does improved sensibility imply functional benefits? J Plast Reconstr Aesthet Surg 2015;68:1025-35. https://doi.org/10.1016/j.bjps.2015.04.020
  5. Bokhari WA, Wang SJ. Tongue reconstruction: recent advances. Curr Opin Otolaryngol Head Neck Surg 2007;15:202-7. https://doi.org/10.1097/MOO.0b013e3281fbd406
  6. Chepeha DB, Teknos TN, Shargorodsky J, Sacco AG, Lyden T, Prince ME, et al. Rectangle tongue template for reconstruction of the hemiglossectomy defect. Arch Otolaryngol Head Neck Surg 2008;134:993-8. https://doi.org/10.1001/archotol.134.9.993
  7. Hsiao HT, Leu YS, Liu CJ, Tung KY, Lin CC. Radial forearm versus anterolateral thigh flap reconstruction after hemiglossectomy: functional assessment of swallowing and speech. J Reconstr Microsurg 2008;24:85-8. https://doi.org/10.1055/s-2008-1076097
  8. Engel H, Huang JJ, Lin CY, Lam W, Kao HK, Gazyakan E, et al. A strategic approach for tongue reconstruction to achieve predictable and improved functional and aesthetic outcomes. Plast Reconstr Surg 2010;126:1967-77. https://doi.org/10.1097/PRS.0b013e3181f44742
  9. Song R, Song Y, Yu Y, Song Y. The upper arm free flap. Clin Plast Surg 1982;9:27-35. https://doi.org/10.1016/S0094-1298(20)30370-9
  10. Klinkenberg M, Fischer S, Kremer T, Hernekamp F, Lehnhardt M, Daigeler A. Comparison of anterolateral thigh, lateral arm, and parascapular free flaps with regard to donor-site morbidity and aesthetic and functional outcomes. Plast Reconstr Surg 2013;131:293-302. https://doi.org/10.1097/PRS.0b013e31827786bc
  11. Reinert S. The free revascularized lateral upper arm flap in maxillofacial reconstruction following ablative tumour surgery. J Craniomaxillofac Surg 2000;28:69-73. https://doi.org/10.1054/jcms.2000.0118
  12. Close LG, Truelson JM, Milledge RA, Schweitzer C. Sensory recovery in noninnervated flaps used for oral cavity and oropharyngeal reconstruction. Arch Otolaryngol Head Neck Surg 1995;121:967-72. https://doi.org/10.1001/archotol.1995.01890090011002
  13. Elfring T, Boliek CA, Winget M, Paulsen C, Seikaly H, Rieger JM. The relationship between lingual and hypoglossal nerve function and quality of life in head and neck cancer. J Oral Rehabil 2014;41:133-40. https://doi.org/10.1111/joor.12116
  14. Chang EI, Yu P, Skoracki RJ, Liu J, Hanasono MM. Comprehensive analysis of functional outcomes and survival after microvascular reconstruction of glossectomy defects. Ann Surg Oncol 2015;22:3061-9. https://doi.org/10.1245/s10434-015-4386-6
  15. Soutar DS, McGregor IA. The radial forearm flap in intraoral reconstruction: the experience of 60 consecutive cases. Plast Reconstr Surg 1986;78:1-8. https://doi.org/10.1097/00006534-198607000-00001
  16. Chang EI, Ibrahim A, Papazian N, Jurgus A, Nguyen AT, Suami H, et al. Perforator mapping and optimizing design of the lateral arm flap: anatomy revisited and clinical experience. Plast Reconstr Surg 2016;138:300e-306e. https://doi.org/10.1097/PRS.0000000000002393
  17. Huang CH, Chen HC, Huang YL, Mardini S, Feng GM. Comparison of the radial forearm flap and the thinned anterolateral thigh cutaneous flap for reconstruction of tongue defects: an evaluation of donor-site morbidity. Plast Reconstr Surg 2004; 114:1704-10. https://doi.org/10.1097/01.PRS.0000142476.36975.07
  18. Busnardo FF, Coltro PS, Olivan MV, Faes JC, Lavor E, Ferreira MC, et al. Anatomical comparison among the anterolateral thigh, the parascapular, and the lateral arm flaps. Microsurgery 2015;35:387-92. https://doi.org/10.1002/micr.22357
  19. Otberg N, Richter H, Schaefer H, Blume-Peytavi U, Sterry W, Lademann J. Variations of hair follicle size and distribution in different body sites. J Invest Dermatol 2004;122:14-9. https://doi.org/10.1046/j.0022-202X.2003.22110.x
  20. Hsu KC, Tsai WH, Ting PS, Hsueh JH, Chen LW, Lin YS. Comparison between anterolateral thigh, radial forearm, and peroneal artery flap donor site thickness in Asian patients: a sonographic study. Microsurgery 2017;37:655-60. https://doi.org/10.1002/micr.30164
  21. Ki SH. Lateral arm free flap with preservation of the posterior antebrachial cutaneous nerve. Ann Plast Surg 2016;76:517-20. https://doi.org/10.1097/SAP.0000000000000296
  22. Ahn HC. Revision of lateral arm free flap; can it be a substitute for radial forearm free flap? Arch Reconstr Microsurg 1997;6: 80-6.
  23. Yang XD, Zhao SF, Wang YX, Li W, Zhang Q, Hong XW, et al. Use of extended lateral upper arm free flap for tongue reconstruction after radical glossectomy for tongue cancer. Aesthetic Plast Surg 2015;39:562-9. https://doi.org/10.1007/s00266-015-0512-x
  24. Yu P. Reinnervated anterolateral thigh flap for tongue reconstruction. Head Neck 2004;26:1038-44. https://doi.org/10.1002/hed.20106
  25. Loewen IJ, Boliek CA, Harris J, Seikaly H, Rieger JM. Oral sensation and function: a comparison of patients with innervated radial forearm free flap reconstruction to healthy matched controls. Head Neck 2010;32:85-95. https://doi.org/10.1002/hed.21155
  26. Biglioli F, Liviero F, Frigerio A, Rezzonico A, Brusati R. Function of the sensate free forearm flap after partial glossectomy. J Craniomaxillofac Surg 2006;34:332-9. https://doi.org/10.1016/j.jcms.2006.04.005
  27. Katou F, Shirai N, Kamakura S, Ohki H, Motegi K, Andoh N, et al. Intraoral reconstruction with innervated forearm flap: a comparison of sensibility and reinnervation in innervated versus noninnervated forearm flap. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995;80:638-44. https://doi.org/10.1016/S1079-2104(05)80243-4
  28. Tincani AJ, Del Negro A, Araujo PP, Akashi HK, Neves Fda S, Martins AS. Head and neck reconstruction using infrahyoid myocutaneous flaps. Sao Paulo Med J 2006;124:271-4. https://doi.org/10.1590/S1516-31802006000500007

피인용 문헌

  1. Tip of the Tongue Reconstruction with Prelaminated Fasciomucosal Radial Forearm Free Flap vol.8, pp.12, 2019, https://doi.org/10.1097/gox.0000000000003226
  2. Reconstruction of Hemiglossectomy Defects With the Lateral Arm Fasciocutaneous Flap vol.32, pp.8, 2019, https://doi.org/10.1097/scs.0000000000007608
  3. Case Report: Superficial Circumflex Iliac Artery Perforator Flap for Tongue Reconstruction Following the Hemiglossectomy vol.8, 2019, https://doi.org/10.3389/fsurg.2021.692331