Functional results after tongue replacement

Aim of the reconstructive surgery of the tongue after tumour resection is to restore speech, deglutition and normal breathing without tracheostomy. Between January 2008 and December 2009 27 patients at Helios Hospital Schwerin received partial and total glossectomy. For partial reconstructions we used radial forearm flaps (n = 20) whereas for the total reconstruction (n = 7) we used a latissimus dorsi flap. Parameters for the postoperative assessment were speech function, the absence of a tracheostomy and of a percutaneous gastrostomy. The results were compared to those achieved by a gracilis flap in similar cases. Articulation was good in 3 cases. Four of the patients had no tracheostomy; with two patients percutaneous gastrostomy had been removed. The free innervated latissimus-dorsi-flap as well as the gracilis flap proved to be stable tools giving sufficient material for the reconstruction after total resection of the tongue with limited but acceptable functional results.