Cargando…

Tip of the Tongue Reconstruction with Prelaminated Fasciomucosal Radial Forearm Free Flap

Tongue cancer is the most common malignant neoplasm of the oral cavity. Occurrence in the tip of the tongue (TOT) is rare. We describe a case report of a TOT tumor excision and reconstruction with a prelaminated fasciomucosal radial forearm free flap. A 41-year-old white man was referred to our depa...

Descripción completa

Detalles Bibliográficos
Autores principales: De Santis, Giorgio, Mattioli, Francesco, Pinelli, Massimo, Martone, Andrea, Starnoni, Marta, Fermi, Matteo, Presutti, Livio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787281/
https://www.ncbi.nlm.nih.gov/pubmed/33425574
http://dx.doi.org/10.1097/GOX.0000000000003226
_version_ 1783632792632950784
author De Santis, Giorgio
Mattioli, Francesco
Pinelli, Massimo
Martone, Andrea
Starnoni, Marta
Fermi, Matteo
Presutti, Livio
author_facet De Santis, Giorgio
Mattioli, Francesco
Pinelli, Massimo
Martone, Andrea
Starnoni, Marta
Fermi, Matteo
Presutti, Livio
author_sort De Santis, Giorgio
collection PubMed
description Tongue cancer is the most common malignant neoplasm of the oral cavity. Occurrence in the tip of the tongue (TOT) is rare. We describe a case report of a TOT tumor excision and reconstruction with a prelaminated fasciomucosal radial forearm free flap. A 41-year-old white man was referred to our department for a squamous cell carcinoma of the tip of the tongue. The patient worked as an air traffic control official; therefore, conservation of speech intelligibility, both in Italian and English language, was of paramount importance. A transoral excision of TOT, bilateral selective neck dissection, and reconstruction with prelaminated fasciomucosal radial forearm free flap were performed. Adjuvant radiotherapy was necessary. The patient was completely re-established as an air traffic control officer. Successful tongue reconstruction of smaller defects depends on thinness, pliability of flap, and conservation of tongue mobility. Surgical options for TOT reconstruction are facial artery muscolomucosa flap, Zhao flap, radial forearm free flap, or primary suture. In the authors’ opinion, a fasciomucosal prelaminated RFFF offers a series of advantages for TOT reconstruction. The absence of subcutaneous tissue makes the PFRFFF much thinner than fascio-cutaneous flaps. Compared with mucosal loco-regional flaps, prelaminated flaps allow the preservation of oral mucosa lining while providing adequate bulk and reduced scar formation for optimal func- tional recovery. In our case report, the fasciomucosal flap allowed an adequate reconstruction of TOT volume with good functional and aesthetic outcomes. The flap’s added bulk and its minimal scar retraction granted free tongue movement and optimal speech intelligibility.
format Online
Article
Text
id pubmed-7787281
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-77872812021-01-07 Tip of the Tongue Reconstruction with Prelaminated Fasciomucosal Radial Forearm Free Flap De Santis, Giorgio Mattioli, Francesco Pinelli, Massimo Martone, Andrea Starnoni, Marta Fermi, Matteo Presutti, Livio Plast Reconstr Surg Glob Open Reconstructive Tongue cancer is the most common malignant neoplasm of the oral cavity. Occurrence in the tip of the tongue (TOT) is rare. We describe a case report of a TOT tumor excision and reconstruction with a prelaminated fasciomucosal radial forearm free flap. A 41-year-old white man was referred to our department for a squamous cell carcinoma of the tip of the tongue. The patient worked as an air traffic control official; therefore, conservation of speech intelligibility, both in Italian and English language, was of paramount importance. A transoral excision of TOT, bilateral selective neck dissection, and reconstruction with prelaminated fasciomucosal radial forearm free flap were performed. Adjuvant radiotherapy was necessary. The patient was completely re-established as an air traffic control officer. Successful tongue reconstruction of smaller defects depends on thinness, pliability of flap, and conservation of tongue mobility. Surgical options for TOT reconstruction are facial artery muscolomucosa flap, Zhao flap, radial forearm free flap, or primary suture. In the authors’ opinion, a fasciomucosal prelaminated RFFF offers a series of advantages for TOT reconstruction. The absence of subcutaneous tissue makes the PFRFFF much thinner than fascio-cutaneous flaps. Compared with mucosal loco-regional flaps, prelaminated flaps allow the preservation of oral mucosa lining while providing adequate bulk and reduced scar formation for optimal func- tional recovery. In our case report, the fasciomucosal flap allowed an adequate reconstruction of TOT volume with good functional and aesthetic outcomes. The flap’s added bulk and its minimal scar retraction granted free tongue movement and optimal speech intelligibility. Lippincott Williams & Wilkins 2020-12-02 /pmc/articles/PMC7787281/ /pubmed/33425574 http://dx.doi.org/10.1097/GOX.0000000000003226 Text en Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Reconstructive
De Santis, Giorgio
Mattioli, Francesco
Pinelli, Massimo
Martone, Andrea
Starnoni, Marta
Fermi, Matteo
Presutti, Livio
Tip of the Tongue Reconstruction with Prelaminated Fasciomucosal Radial Forearm Free Flap
title Tip of the Tongue Reconstruction with Prelaminated Fasciomucosal Radial Forearm Free Flap
title_full Tip of the Tongue Reconstruction with Prelaminated Fasciomucosal Radial Forearm Free Flap
title_fullStr Tip of the Tongue Reconstruction with Prelaminated Fasciomucosal Radial Forearm Free Flap
title_full_unstemmed Tip of the Tongue Reconstruction with Prelaminated Fasciomucosal Radial Forearm Free Flap
title_short Tip of the Tongue Reconstruction with Prelaminated Fasciomucosal Radial Forearm Free Flap
title_sort tip of the tongue reconstruction with prelaminated fasciomucosal radial forearm free flap
topic Reconstructive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787281/
https://www.ncbi.nlm.nih.gov/pubmed/33425574
http://dx.doi.org/10.1097/GOX.0000000000003226
work_keys_str_mv AT desantisgiorgio tipofthetonguereconstructionwithprelaminatedfasciomucosalradialforearmfreeflap
AT mattiolifrancesco tipofthetonguereconstructionwithprelaminatedfasciomucosalradialforearmfreeflap
AT pinellimassimo tipofthetonguereconstructionwithprelaminatedfasciomucosalradialforearmfreeflap
AT martoneandrea tipofthetonguereconstructionwithprelaminatedfasciomucosalradialforearmfreeflap
AT starnonimarta tipofthetonguereconstructionwithprelaminatedfasciomucosalradialforearmfreeflap
AT fermimatteo tipofthetonguereconstructionwithprelaminatedfasciomucosalradialforearmfreeflap
AT presuttilivio tipofthetonguereconstructionwithprelaminatedfasciomucosalradialforearmfreeflap