ABSTRACT
From October 1999 to July 2005, defects after total glossectomy with laryngectomy
(TGL) for cancer of the tongue or middle pharynx were reconstructed with rectus abdominis
myocutaneous (RAMC) flaps in nine patients. The skin flaps were designed larger in
width than the original defect to create a funnel-shaped oropharynx and prevent stricture.
Six patients had uneventful postoperative courses and began to eat perorally 8 to
15 days postoperatively. One patient suffered flap necrosis due to arterial thrombosis
and two patients had leakage. Eventually, eight patients could eat soft foods or gruel,
except one patient who had ingested food through a gastrostomy preoperatively. When
TGL was performed without mandibulectomy, the blood supply for the remnant mucosa
of the backside of the mandible is generally not good, for which the reconstruction
with the overlapping deepithelialized flap and muscle is useful for prevention of
the fistula formation. We considered that the RAMC flap is a good option for reconstruction
after TGL.
KEYWORDS
Total glossectomy with laryngectomy - reconstruction - rectus abdominis myocutaneous
flap
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Mutsumi OkazakiM.D.
Department of Plastic and Reconstructive Surgery, Kyorin University
6-20-2 Shinkawa, Mitaka-City, Tokyo, Japan 181-8611