A NEW METHOD FOR TONGUE RECONSTRUCTION - THE NEUROVASCULAR INFRAHYOIDAL MYOFASCIAL FLAP

Surgical treatment of tongue cancer can lead to extended defunctionali sation, depending upon the size and localisation of the defect. Great problems of swallowing aris after total glossectomy or extensive resec tions of the base of the tongue even after reconstruction with myocuta neous island flaps or free flaps. We developed a neuromuscular island flap derived from the infrahyoidal musculature to reconstruct a total tongue or large defects of the tongue base. This fasciomuscular flap i s formed by the M. stereothyroideus, M. stereohyoideus and the upper p art of the M. omohyoideus. The axial blood supply arises from the A. t hyroidea sup. The innervation is derived from the Ansa cervicalis N. h ypoglossi. In case of total glossectomy we took this flap from both si des of the neck. With this new method we reconstructed total tongues a fter glossectomy in two patients and large defects of the tongue base in six patients. In the present paper the new surgical method and the functional results are described.