Skip to main content

Tongue and Floor of Mouth Defect Reconstruction

  • Chapter
  • First Online:
Contemporary Oral Oncology

Abstract

The tongue and floor of the mouth represents an anatomically small compartment within the head and neck, but it is a complex collision of tissue types and function. This area is perhaps often overlooked in the hierarchy of importance due to the concealment of the overlying lips and maxillomandibular complexes, but nonetheless demands the utmost attention to the reconstructive surgeon. There are numerous tissues of distinct embryologic origins that interface with one another. Applying a thorough understanding of the relevant surgical anatomy, reconstructive options, and scientific information can lead to individually tailored approaches which optimize surgical outcomes. The focus of this chapter will be on reconstruction of the tongue and floor of the mouth defects that are compositely less than or equal to a hemiglossectomy. There will be a systematic and straightforward approach that both the neophyte and seasoned surgeon alike can glean from.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  1. Urken ML, Moscoso JF, Lawson W, Biller HF. A systemic approach to functional reconstruction of the oral cavity following partial and total glossectomy. Arch Otolaryngol Head Neck Surg. 1994;120(6):589–601.

    Article  CAS  Google Scholar 

  2. Urken ML, Weinberg H, Vickery C, Buchbinder D, Lawson W, Biller HF. Oromandibular reconstruction using microvascular composite free flaps: report of 71 cases and a new classification scheme for bony, soft tissue and neurologic defects. Ach Otolaryngol Head Neck Surg. 1991;117:733–44.

    Article  CAS  Google Scholar 

  3. Bokhari WA, Wang SJ. Tongue reconstruction: recent advances. Curr Opin Otolaryngol Head Neck Surg. 2007;15(4):202–7.

    Article  Google Scholar 

  4. Sieczka EM, Weber RV. Climbing the reconstructive ladder in the head and neck. Mo Med. 2006;103(3):265–9.

    PubMed  Google Scholar 

  5. Smith RB, Sniezek JC, Weed DT, Wax MK. Utilization of free tissue transfer in head and neck surgery. Otolaryngol Head Neck Surg. 2007;137(2):182–91.

    Article  Google Scholar 

  6. McConnell FM. Analysis of pressure generation and bolus transit during pharyngeal swallowing. Laryngoscope. 1988;98:71–8.

    Google Scholar 

  7. Lee DY, Ryu YJ, Hah JH, Kwon TK, Sung MW, Kim KH. Long-term subjective function after partial glossectomy. J Oral Rehabil. 2014;41(10):754–8.

    Article  CAS  Google Scholar 

  8. Lam L, Samman N. Speech and swallowing following tongue cancer surgery and free flap reconstruction – a systematic review. Oral Oncol. 2013;49:507–24.

    Article  Google Scholar 

  9. Pierre CS, Dassonville O, Chamorey E, Poissonnet G, Riss JC, Ettaiche M, Peyrade F, Benezery K, Chand ME, Leyssalle A, Sudaka A, Haudebourg J, Santini J, Bozec A. Long-term functional outcomes and quality of life after oncologic surgery and microvascular reconstruction in patients with oral or oropharyngeal cancer. Acta Otolaryngol. 2014;134(10):1086–93.

    Article  Google Scholar 

  10. Nesse W, Hoekema A, Stegenga B, van der Hoeven JH, de Bont LG, Roodenburg JL. Prevalence of obstructive sleep apnoea following head and neck cancer treatment: a cross-sectional study. Oral Oncol. 2006;42(1):108–14.

    Article  Google Scholar 

  11. Gilat H, Shpitzer T, Guttman D, Soudry E, Feinmesser R, Bachar G. Obstructive sleep apnea after radial forearm free flap reconstruction of the oral tongue. Laryngoscope. 2013;123:3223–6.

    Article  Google Scholar 

  12. Moore K, Dalley A. Clinically oriented anatomy. 5th ed. Philadelphia: Lippincott William and Wilkins; 2006. p. 1003–9.

    Google Scholar 

  13. Brand R, Isselhard D. Anatomy of orofacial structures. St. Louis: Mosby; 2003. p. 300–15.

    Google Scholar 

  14. Strauss R, Kain N. Tongue flaps. Oral Maxillofacial Surg Clin N Am. 2014;26:313–25.

    Article  Google Scholar 

  15. Schramm V, Myers E. Skin grafts in oral cavity reconstruction. Arch Otolaryngol. 1980;106:175–7.

    Article  Google Scholar 

  16. Butler C. “Tongue Sandwich” bolster for skin graft immobilization. Head Neck. 2002;24(7):705–9.

    Article  Google Scholar 

  17. Baudet D, Pascal J, Baudet J, et al. The submental island flap: a new donor site. Anatomy and clinical applications as a free or pedicled flap. Plast Reconstr Surg. 1993;92:867–73.

    Article  Google Scholar 

  18. Parmar P, Goldstein D. The submental island flap in head and neck reconstruction. Curr Opin Otolaryngol Head Neck Surg. 2009;17:263–6.

    Article  Google Scholar 

  19. Cheng A, Bui T. Submental island flap. Oral Maxillofacial Surg Clin N Am. 2014;26:371–9.

    Article  Google Scholar 

  20. Howard B, Nagel T, Donald C, Hinni M, Hayden R. Oncologic safety of the submental flap for reconstruction in oral cavity malignancies. Otolaryngol Head Neck Surg. 2014;150(4):558–62.

    Article  Google Scholar 

  21. Rahpeyma A, Khajehahmadi S. Submental artery island flap in intraoral reconstruction: a review. J Craniomaxillofac Surg. 2014;42(6):983–9.

    Article  Google Scholar 

  22. Merten S, Jiang R, Caminer D. The submental artery island flap for head and neck reconstruction. Aust N Z J Surg. 2002;72:121–4.

    Article  CAS  Google Scholar 

  23. Patel UA, Bayles SW, Hayden RE. The submental flap: a modified technique for resident training. Laryngoscope. 2007;117:186–9.

    Article  Google Scholar 

  24. Tessier P, Matthews DC, Kamerer Jr D, Ciminello FS, Gargano F, Wolfe SA. Platysma-based myocutaneous clavicular island flap for intraoral reconstruction. Ann Plast Surg. 2011;67(6):S55–69.

    Article  CAS  Google Scholar 

  25. Lafont Rufat M, Nadal Cristobal B, Saura Fillat E, Ruiz de la Cuesta Martín D. Platysma flap: an alternative to free flaps. J Maxillofac Oral Surg. 2014;13(2):84–6.

    Article  Google Scholar 

  26. Baur DA, Williams J, Alakaily X. The platysma myocutaneous flap. Oral Maxillofac Surg Clin North Am. 2014;26(3):381–7.

    Article  Google Scholar 

  27. Taylor GI, Ham FJ. The free vascularized nerve graft. A further experimental and clinical application of microvascular techniques. Plast Reconstr Surg. 1976;57:413.

    Article  CAS  Google Scholar 

  28. Yang G, Chen B, Gao Y, et al. Forearm free skin flap transplantation. Natl Med J China. 1981;61:139.

    Google Scholar 

  29. Urken ML, Biller HF. A new design for the sensate radial forearm flap to persevere tongue mobility following significant glossectomy. Arch Otolaryngol Head Neck Surg. 1994;120:26–31.

    Article  CAS  Google Scholar 

  30. Seikaly H, Rieger J, O’Connell D, Ansari K, Alqahtani K, Harris J. Beavertail modification of the radial forearm free flap in base of tongue reconstruction: technique and functional outcomes. Head Neck. 2009;31(2):213–9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Brent B. Ward DDS, MD, FACS .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Brockhoff, H.C., Ward, B.B. (2017). Tongue and Floor of Mouth Defect Reconstruction. In: Kuriakose, M.A. (eds) Contemporary Oral Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-43854-2_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-43854-2_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43852-8

  • Online ISBN: 978-3-319-43854-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics