ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Risk Level Varies during Free Flap Reconstruction of Glossectomy Defects

by Literature Reviews • July 11, 2017

  • Tweet
  • Email
Print-Friendly Version

What are the preoperative variables, mean operative time, morbidity, and mortality associated with reconstruction of partial glossectomy defects?

Bottom line
Free flap reconstruction of glossectomy defects involving up to half of the tongue is associated with increased morbidity and operative time when compared with nonflap reconstruction. Currently available functional outcomes data for tongue reconstruction are poor. Possible functional impairment must be weighed against the associated morbidity when deciding which defects require reconstruction, and the decision to reconstruct should not be taken lightly.

You Might Also Like

  • Free Flap Surgery Viable Choice for Mandible Reconstruction
  • Regional Flap vs. Free Flap Reconstruction: Point–Counterpoint
  • Fibula and Osteocutaneous Radial Forearm Free Flap Are Comparable
  • Better Consensus Needed for Anticoagulation Use Following HN Free Flap Procedures
Explore This Issue
July 2017

Background: The tongue remains the most common site of primary oral cavity malignant neoplasms. The type of reconstruction used for defects following ablative surgical treatment of tongue cancer is highly dependent on the extent of the resection. Tongue resections are generally classified into four groups: partial, hemi, subtotal, and total glossectomy. The degree of swallowing and speech functional impairment is dependent on the extent of tissue removed as well as the degree of functionality of residual tongue tissue. Algorithms have been established to dictate the most adequate types of reconstructions available for a given size of glossectomy defect. Over recent years, several quality of life (QOL) instruments have been adapted to study the head and neck population. Interestingly, certain studies have shown that patients undergoing reconstructions of small partial glossectomy defects may actually have worse QOL scores related to speech and swallowing than those undergoing primary closure or granulation. Furthermore, overall QOL scores of patients undergoing partial glossectomies with primary closures or granulation have been shown to be reasonably high, substantiating the argument that patients undergoing limited glossectomies should be spared the potential added morbidity of free flap reconstructions.

Study Design: Retrospective data analysis.

Synopsis: The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients who had received glossectomy procedures. The study sample was split into two groups based on the lack or presence of a flap reconstruction. A total of 1,012 glossectomy patients were identified, with 805 undergoing nonflap reconstruction and 207 undergoing free flap reconstruction. Variables evaluated included wound complications, major and minor morbidity, return to the operating room, mortality, and mean operative time. Patients undergoing free flap reconstruction experienced significantly longer mean operative times (482.1 vs. 183.0 minutes), were more likely to return to the operating room, and had higher likelihood of wound complications, major morbidity, and minor morbidity. There was no difference in mortality between groups (See Figure 1).

Figure 1. Granulation postoperatively. (A–C) Patient six months after partial glossectomy involving one-third of the tongue and small area of lateral floor of mouth. (D–F) Patient 15 months after partial glossectomy involving one-third of the tongue and lateral floor of mouth. Note adequate tongue protrusion with only mild tethering in both patients Credit: Copyright 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Figure 1. Granulation postoperatively. (A–C) Patient six months after partial glossectomy involving one-third of the tongue and small area of lateral floor of mouth. (D–F) Patient 15 months after partial glossectomy involving one-third of the tongue and lateral floor of mouth. Note adequate tongue protrusion with only mild tethering in both patients.
Credit: Copyright 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Citation: Khan MN, Perez P, Goljo E, et al. The price of free tissue transfer after tongue reconstruction: quantifying the risks. Laryngoscope. 2017;127:1551–1557.

Pages: 1 2 | Multi-Page

Filed Under: Facial Plastic/Reconstructive, Literature Reviews Tagged With: facial reconstruction, Free Flap Reconstruction, glossectomy defects, morbidity rate, riskIssue: July 2017

You Might Also Like:

  • Free Flap Surgery Viable Choice for Mandible Reconstruction
  • Regional Flap vs. Free Flap Reconstruction: Point–Counterpoint
  • Fibula and Osteocutaneous Radial Forearm Free Flap Are Comparable
  • Better Consensus Needed for Anticoagulation Use Following HN Free Flap Procedures

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Vertigo in the Elderly: What Does It Mean?
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Is Middle Ear Pressure Affected by Continuous Positive Airway Pressure Use?
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Why Virtual Grand Rounds May Be Here to Stay
    • Otolaryngologist Leverages His Love of Pinball into Second Business
    • These New Imaging Advances May Help to Protect Parathyroids
    • Is the Training and Cost of a Fellowship Worth It? Here’s What Otolaryngologists Say
    • Which Otologic Procedures Poses the Greatest Risk of Aerosol Generation?

Polls

Have you used 3D-printed materials in your otolaryngology practice?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.