Reconstruction with Rectus Abdominis Myocutaneous Flap for Total Glossectomy with Laryngectomy

Mutsumi Okazaki; Hirotaka Asato; Akihiko Takushima; Shunji Sarukawa; Masayuki Okochi; Hirotaka Suga; Kiyonori Harii

doi:10.1055/s-2007-981502

Journal of Reconstructive Microsurgery, Table of Contents

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

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

Abstract

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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References

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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