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2004, Number 6

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Cir Cir 2004; 72 (6)

Total glossectomy with larynx preservation and reconstruction with rectus abdominis free flap

Luna-Ortiz K, Rascón-Ortiz M, Granados-García M, Rojas-Calvillo A, Herrera-Gómez A
Full text How to cite this article

Language: Spanish
References: 7
Page: 453-456
PDF size: 71.05 Kb.


Key words:

Total glossectomy, Larynx, Rectus abdominis free flap, Cancer, Microsurgery, Gastrostomy..

ABSTRACT

Objective: Our objective was to show the complexity and series of events needed to perform the reconstruction with rectus abdominis free flap to achieve an adequate rehabilitation for patients submitted to total glossectomy with larynx preservation due to advanced tongue carcinoma. Material and Methods: Two patients with stage IV carcinoma of the tongue were treated with surgery- one as primary treatment, the other for recurrence. Patients underwent total glossectomy, bilateral radical neck dissection, gastrostomy, tracheostomy, and reconstruction with rectus abdominis free flap. Results: Both patients had an uneventful postoperative evolution and were discharged from the hospital without tracheostomy on the 7th and 8th days, respectively. The patient who received primary treatment is currently receiving adjuvant radiotherapy. Conclusions: Patients requiring total glossectomy, either with or without laryngectomy, must undergo a careful and individualized selection of the reconstructive procedure by a highly specialized surgical team. The rectus abdominis flap represents one of the best options for reconstruction in patients treated with total glossectomy. Its main disadvantage is seen in overweight patients, in whom the flap volume taken may be excessive for the oral cavity. Most of these patients are fed by a gastrostomy tube, which may be removed only when aspiration is absent. The type of gastrostomy can even be evaluated before surgery.


REFERENCES

  1. Lyos AT, Evans GRD, Perez D, Schusterman MA. Tongue reconstruction: outcomes with the rectus abdominis flap. Plast Reconstr Surg 1999;103:442-447.

  2. Haughey BH, Taylor M, Fuller D. Fasciocutaneous flap reconstruction of the tongue and floor of mouth. Outcomes and techniques. Arch Otolaryngol Head Neck Surg 2002;128:1388-1395.

  3. Luna-Ortiz K, Monnier P, Pasche P. Percutaneous endoscopic gastrostomy as a multidisciplinary treatment in head and neck cancer. Rev Oncol 2002;4:22-27.

  4. Blackwell KE, Chandler CF, Hiyama DT. Gastrostomy tube insertion during rectus free flap harvest: indications, technique and outcome. Laryngoscope 1999;109:161-163.

  5. Wanamaker JR, Burkey BB. Overview of the rectus abdominis myocutaneous flap in head and neck reconstruction. Facial Plast Surg 1996;12:45-50.

  6. Luna-Ortiz K, Jaques B, Monnier P, Escobar-Alfaro G, Pasche P. Colgajos libres microvasculares: opciones para la reconstrucción del piso anterior de la boca después de tratamiento oncológico. Rev Inst Nac Cancerol 1999;45:27-32.

  7. Luna-Ortiz K, Jaques B, Monnier P, Pasche P. Functional evaluation after reconstruction of the anterior floor of the mouth with free flaps in patients with head and neck cancer. Rev Oncol 2002;4:133-138.




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C?MO CITAR (Vancouver)

Cir Cir. 2004;72