Functional Reconstruction of a Hemiglossectomy Defect With an Innervated Musculocutaneous Submental Artery Island Flap

Abstract

This report presents the use of an innervated musculocutaneous submental artery island flap (MSAIF) for the functional reconstruction of a hemiglossectomy defect, with the aim of preserving the volume and mobility of the reconstructed tongue to facilitate swallowing and intelligible speech. A 30-year-old male patient diagnosed with T3N0 stage squamous-cell carcinoma of the tongue underwent hemiglossectomy and ipsilateral I-IV selective neck dissection. For reconstruction, an innervated MSAIF with a 9x4 cm skin paddle, including the left submental vessels, ipsilateral anterior belly of the digastric muscle, mylohyoid muscle, and mylohyoid nerve, was harvested and inserted into the tongue defect. Postoperative healing at both donor and recipient sites proceeded without complications. At a three-year follow-up, the MSAIF has maintained its volume, mobility, and contractility. The patient remains disease-free and reports satisfaction with his swallowing and speech capabilities. The innervated MSAIF represents a reliable and cost-effective reconstruction approach for hemiglossectomy defects, showing favorable results in both swallowing and speech.

Keywords: anterior belly of digastric muscle; functional tongue reconstruction; innervated submental artery island flap; mylohyoid muscle; mylohyoid nerve.