J Reconstr Microsurg 2007; 23(5): 243-249
DOI: 10.1055/s-2007-981502
© Thieme Medical Publishers

Reconstruction with Rectus Abdominis Myocutaneous Flap for Total Glossectomy with Laryngectomy

Mutsumi Okazaki1 , Hirotaka Asato2 , Akihiko Takushima1 , Shunji Sarukawa3 , Masayuki Okochi4 , Hirotaka Suga5 , Kiyonori Harii1
  • 1Department of Plastic and Reconstructive Surgery, Kyorin University, School of Medicine, Tokyo, Japan
  • 2Department of Plastic and Reconstructive Surgery, School of Medicine, Dokkyo University, Tochigi, Japan
  • 3Division of Plastic and Reconstructive Surgery, Jichi Medical School, Tochigi, Japan
  • 4Department of Plastic and Reconstructive Surgery, Fukushima Medical University, Fukushima, Japan
  • 5Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
Further Information

Publication History

Publication Date:
18 September 2007 (online)

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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.