Tongue reconstruction: Rebuilding mobile three-dimensional structures from immobile two-dimensional substrates, a fresh cadaver study

Head Neck. 2019 Oct;41(10):3693-3699. doi: 10.1002/hed.25889. Epub 2019 Jul 26.

Abstract

Objective: To determine the two-dimensional (2D) characteristics of flaps necessary to create three-dimensional (3D) tongue anatomy.

Methods: Dissection of 11 fresh, nonpreserved human cadavers was performed. Six defects in each were created: total tongue, total oral tongue, hemiglossectomy, oral hemiglossectomy, total base of tongue, and hemi-base of tongue. The resections were debulked to create flat, 2D mucosal flaps. The dimensions and shapes of these flaps were determined.

Results: Each specimen showed consistent dimensions and geometry between cadavers. The total tongue was pear-shaped, the total oral tongue was egg-shaped, the oral hemi-tongue was bullet-shaped, the hemi-tongue resembled a dagger, the total base of tongue was rectangular, and the hemi-base of tongue was hour-glass shaped.

Conclusion: Typical dimensions and shapes of common tongue defects were determined. It is conceivable that customizing reconstructive flaps based on these data will increase the accuracy of neo-tongue reconstruction, and thus, improve functional outcomes.

Keywords: free flap; head and neck cancer; oral cancer; oropharyngeal cancer; reconstructive surgery; tongue reconstruction.

MeSH terms

  • Aged
  • Cadaver
  • Female
  • Glossectomy / methods
  • Humans
  • Imaging, Three-Dimensional*
  • Male
  • Mouth Mucosa / transplantation*
  • Plastic Surgery Procedures / methods*
  • Sensitivity and Specificity
  • Surgical Flaps / transplantation*
  • Tongue / surgery*