A device for immediate reconstruction of the tongue by musculocutaneous or fasciocutaneous flap

It is important to reconstruct the tongue by adequate flaps to use remaining tissues with some functions for patients with tongue cancer. We present our device for tongue reconstruction in 110 cases. One of the keys to obtain good postoperative results is to reconstruct the tongue as a protuberant shape which helps the remaining oral function in articulation and swallowing. In case of wide excision of the tongue we apply diaphragm reconstruction of the oral floor as well as tongue reconstruction by using a rectus abdominis musculocutaneous flap. Diaphragm reconstruction has two important meanings in functional reconstruction. One is to prevent postoperative decrease of intraoral volume of the flap and the other is to prevent misswallowing by pulling up the larynx. In the case of hemiglossectomy, a forearm or rectus abdominis musculocutaneous flap can be applied. In fatty patients a forearm flap is better and in slender patients a rectus abdominis flap is suitable. An elliptical-shaped design is usually adopted with partial deepithelialization of the flap, which is transferred to the base of the tongue. The long axis of the flap is about 15 cm with a width of 5 cm. After the flap is fixed, it is checked whether the tip of the reconstructive tongue has enough mobility.