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J Reconstr Microsurg 2008; 24(5): 343-350
DOI: 10.1055/s-2008-1080537
© Thieme Medical Publishers

Functional Reconstruction of Glossectomy Defects: The Vertical Rectus Abdominus Myocutaneous Neotongue

Nicholas T. Haddock1 , Mark D. DeLacure1 , Pierre B. Saadeh1
  • 1Division of Plastic Surgery, The Institute of Reconstructive Plastic Surgery, NYU Medical Center, New York, New York
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Publication History

Publication Date:
02 July 2008 (online)

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ABSTRACT

The vertical rectus abdominus myocutaneous (VRAM) flap is a valuable option for tongue reconstruction. However, the traditional inset (skin to remaining oral mucosa) obviates a more anatomic reconstruction. Eight patients underwent total or subtotal glossectomy with VRAM reconstruction. The muscle inset was supported at the inferior mandibular border attached to the remaining lingual mucosa or gingiva. The neotongue, consisting of skin and subcutaneous fat, was sutured posteriorly to the remaining tongue base, and the other surfaces were trimmed and left unsutured. Reconstruction was successful in all patients. The neotongue assumed palatal configuration, and within 2 weeks uniform granulation tissue followed by mucosalization occurred. One year postoperatively, all patients tolerated ad lib diets, spoke intelligibly, were gastrostomy tube and tracheotomy free and had no evidence of aspiration. This neotongue sits on the mandible under voluntary control, permitting effective obturation against the hard palate and providing successful speech and swallowing.

KEYWORDS

Vertical rectus abdominus myocutaneous - VRAM - glossectomy - reconstruction

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Pierre B SaadehM.D. 

Assistant Professor, Division of Plastic Surgery, NYU Medical Center

560 First Avenue, TH 169, New York, NY 10016

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