Free Vertical Latissimus Dorsi Flap for Tongue Reconstruction After Total Glossectomy

Giljoon Lee; Yong June Chang; Jongmoo Park; Jeong Yeop Ryu; Kang Young Choi; Jung Dug Yang; Ho Yun Chung; Byung Chae Cho; Byungju Kang; Jeeyeon Lee; Joon Seok Lee

doi:10.21873/invivo.13381

Free Vertical Latissimus Dorsi Flap for Tongue Reconstruction After Total Glossectomy

In Vivo. 2023 Nov-Dec;37(6):2710-2718. doi: 10.21873/invivo.13381.

Authors

Affiliations

¹ Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
² Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
³ Department of Radiation Oncology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
⁴ Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
⁵ Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea; leejspo@knu.ac.kr.

Abstract

Background/aim: The tongue is an important anatomical structure, playing an significant role in natural speech, swallowing, and sense of taste. Immediate reconstruction using autologous tissue must be performed following glossectomy for tongue cancer to improve patient quality of life. This study aimed to demonstrate the usefulness of a surgical technique using the free vertical latissimus dorsi flap (FvLDF) for tongue reconstructions using autologous tissue.

Patients and methods: Among patients who underwent total glossectomy for tongue cancer from November 2014 to February 2023, we selected 10 patients who underwent immediate tongue reconstruction with a radial free forearm flap (RFFF) or free anterolateral thigh flap and four patients who underwent FvLDF. The patients were compared regarding postoperative function (width of oropharyngeal space in computed tomography, language-speech evaluation), aesthetic results, and features.

Results: All four patients who underwent FvLDF showed successful flap survival, with no severe complications. Because vertical incision was made during flap harvest with primary closure possible with the mid-axillary line, donor morbidity was significantly lower in patients who underwent reconstruction with FvLDF than in those who underwent reconstruction with RFFF, and good aesthetic results were obtained. In comparing the oropharyngeal space of patients on neck CT preoperatively and postoperatively, the width increase rate of patients who underwent reconstruction with FvLDF was significantly smaller. FvLDF patients demonstrated good speech and swallowing functions.

Conclusion: Considering the advantages of reconstruction with FvLDF in terms of features and aesthetic results, this surgical technique may be a reliable alternative technique for tongue defects after glossectomy.

Keywords: Free vertical latissimus dorsi flap; glossectomy; radial free forearm flap; tongue cancer; tongue reconstruction.

MeSH terms

Free Tissue Flaps*
Glossectomy / methods
Humans
Quality of Life
Superficial Back Muscles*
Tongue / surgery
Tongue Neoplasms* / surgery