대한두개안면성형외과학회지 (Archives of Craniofacial Surgery)

  • 제23권4호
  • /
  • Pages.139-151
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  • 2022
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  • 2287-1152(pISSN)
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  • 2287-5603(eISSN)
대한두개안면성형외과학회 (Korean Cleft Palate-Craniofacial Association)
권호 표지
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Current status and evolution of microsurgical tongue reconstructions, part I

  • Choi, Jong-Woo (Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Alshomer, Feras (Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Young-Chul (Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2022.05.10
  • 심사 : 2022.06.13
  • 발행 : 2022.08.20
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초록

Reconstructive surgery in the management of head and neck cancer has evolved to include structure-specific approaches in which organ-specific treatment algorithms help optimize outcomes. Tongue cancer management and reconstruction are surgical challenges for which well-executed reconstructive plans should be completed promptly to avoid delaying any subsequently planned oncologic treatment. Crucial considerations in tongue cancer resection are the significant functional morbidity associated with surgical defects, particularly in terms of speech and swallowing, and the consequent negative impact on patients' quality of life. With the evolution of microsurgical techniques and the development of the perforator flap concept, flap options can be tailored to the characteristics of various tongue defects. This has allowed the implementation of pliable flaps that can help restore tongue mobility and yield subsequent functional outcomes. Using an evolutional framework, we present this series of reviews related to tongue reconstruction. The first part of the review summarizes flap options and flap-related factors, such as volume and tissue characteristics. Related functional aspects are also presented, including tongue mobility, speech, and swallowing, as well as ways to evaluate and optimize these outcomes.

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참고문헌

  1. Urken ML, Moscoso JF, Lawson W, Biller HF. A systematic approach to functional reconstruction of the oral cavity following partial and total glossectomy. Arch Otolaryngol Head Neck Surg 1994;120:589-601. https://doi.org/10.1001/archotol.1994.01880300007002
  2. Vincent A, Kohlert S, Lee TS, Inman J, Ducic Y. Free-flap reconstruction of the tongue. Semin Plast Surg 2019;33:38-45. https://doi.org/10.1055/s-0039-1677789
  3. Chung JH, Kim KJ, Jung KY, Baek SK, Park SH, Yoon ES. Recipient vessel selection for head and neck reconstruction: a 30-year experience in a single institution. Arch Craniofac Surg 2020;21:269-75. https://doi.org/10.7181/acfs.2020.00339
  4. Manrique OJ, Leland HA, Langevin CJ, Wong A, Carey JN, Ciudad P, et al. Optimizing outcomes following total and subtotal tongue reconstruction: a systematic review of the contemporary literature. J Reconstr Microsurg 2017;33:103-11. https://doi.org/10.1055/s-0036-1593772
  5. Ward GE, Edgerton MT, Chambers RG, McKee DM. Cancer of the oral cavity and pharynx and results of treatment by means of the composite operation (in continuity with radical neck dissection). Ann Surg 1959;150:202-20. https://doi.org/10.1097/00000658-195908000-00004
  6. Absolon KB, Rogers W, Aust JB. Some historical developments of the surgical therapy of tongue cancer from the seventeenth to the nineteenth century. Am J Surg 1962;104:686-91. https://doi.org/10.1016/0002-9610(62)90419-1
  7. Gilbert RW. Reconstruction of the oral cavity; past, present and future. Oral Oncol 2020;108:104683. https://doi.org/10.1016/j.oraloncology.2020.104683
  8. Ariyan S. The pectoralis major myocutaneous flap: a versatile flap for reconstruction in the head and neck. Plast Reconstr Surg 1979;63:73-81. https://doi.org/10.1097/00006534-197901000-00012
  9. Sieczka EM, Weber RV. Climbing the reconstructive ladder in the head and neck. Mo Med 2006;103:265-9.
  10. Smith RB, Sniezek JC, Weed DT, Wax MK; Microvascular Surgery Subcommittee of American Academy of OtolaryngologyHead and Neck Surgery. Utilization of free tissue transfer in head and neck surgery. Otolaryngol Head Neck Surg 2007;137: 182-91. https://doi.org/10.1016/j.otohns.2007.04.011
  11. Ye W, Hu J, Zhu H, Zhang Z. Tongue reconstruction with tongue base island advancement flap. J Craniofac Surg 2013;24: 996-8. https://doi.org/10.1097/SCS.0b013e31828f1a6b
  12. Nueangkhota P, Liang YJ, Zheng GS, Su YX, Yang WF, Liao GQ. Reconstruction of tongue defects with the contralateral nasolabial island flap. J Oral Maxillofac Surg 2016;74:851-9. https://doi.org/10.1016/j.joms.2015.10.013
  13. Joseph ST, Naveen BS, Mohan TM. Islanded facial artery musculomucosal flap for tongue reconstruction. Int J Oral Maxillofac Surg 2017;46:453-5. https://doi.org/10.1016/j.ijom.2016.11.010
  14. Sittitrai P, Reunmakkaew D, Srivanitchapoom C. Submental island flap versus radial forearm free flap for oral tongue reconstruction: a comparison of complications and functional outcomes. J Laryngol Otol 2019;133:413-8. https://doi.org/10.1017/S0022215119000744
  15. Bokhari WA, Wang SJ. Tongue reconstruction: recent advances. Curr Opin Otolaryngol Head Neck Surg 2007;15:202-7. https://doi.org/10.1097/MOO.0b013e3281fbd406
  16. Suh JM, Chung CH, Chang YJ. Head and neck reconstruction using free flaps: a 30-year medical record review. Arch Craniofac Surg 2021;22:38-44. https://doi.org/10.7181/acfs.2020.00745
  17. Hanasono MM, Matros E, Disa JJ. Important aspects of head and neck reconstruction. Plast Reconstr Surg 2014;134:968e980e.
  18. Hartl DM, Dauchy S, Escande C, Bretagne E, Janot F, Kolb F. Quality of life after free-flap tongue reconstruction. J Laryngol Otol 2009;123:550-4. https://doi.org/10.1017/S0022215108003629
  19. Chen WL, Yang ZH, Li JS, Huang ZQ. Reconstruction of the tongue using an extended vertical lower trapezius island myocutaneous flap after removal of advanced tongue cancer. Br J Oral Maxillofac Surg 2008;46:379-82. https://doi.org/10.1016/j.bjoms.2007.11.009
  20. Engel H, Huang JJ, Lin CY, Lam W, Kao HK, Gazyakan E, et al. A strategic approach for tongue reconstruction to achieve predictable and improved functional and aesthetic outcomes. Plast Reconstr Surg 2010;126:1967-77. https://doi.org/10.1097/PRS.0b013e3181f44742
  21. Oh J, Lee TH, Lee JH, Tae K, Park SO, Ahn HC. Exclusive tongue tip reconstruction of hemiglossectomy defects using the underrated lateral arm free flap with bilobed design. Arch Craniofac Surg 2019;20:37-43. https://doi.org/10.7181/acfs.2018.02005
  22. de Vicente JC, de Villalain L, Torre A, Pena I. Microvascular free tissue transfer for tongue reconstruction after hemiglossectomy: a functional assessment of radial forearm versus anterolateral thigh flap. J Oral Maxillofac Surg 2008;66:2270-5. https://doi.org/10.1016/j.joms.2008.01.018
  23. Benanti E, Starnoni M, Spaggiari A, Pinelli M, De Santis G. Objective selection criteria between ALT and radial forearm flap in oral soft tissues reconstruction. Indian J Plast Surg 2019; 52:166-70. https://doi.org/10.1055/s-0039-1693504
  24. Baas M, Duraku LS, Corten EM, Mureau MA. A systematic review on the sensory reinnervation of free flaps for tongue reconstruction: does improved sensibility imply functional benefits? J Plast Reconstr Aesthet Surg 2015;68:1025-35. https://doi.org/10.1016/j.bjps.2015.04.020
  25. Cai YC, Li C, Zeng DF, Zhou YQ, Sun RH, Shui CY, et al. Comparative analysis of radial forearm free flap and anterolateral thigh flap in tongue reconstruction after radical resection of tongue cancer. ORL J Otorhinolaryngol Relat Spec 2019;81: 252-64. https://doi.org/10.1159/000502151
  26. Liao G, Su Y, Zhang J, Hou J, Chen Y, Li M. Reconstruction of the tongue with reinnervated rectus abdominis musculoperitoneal flaps after hemiglossectomy. J Laryngol Otol 2006;120: 205-13. https://doi.org/10.1017/S002221510600017X
  27. Haughey BH, Fredrickson JM. The latissimus dorsi donor site: current use in head and neck reconstruction. Arch Otolaryngol Head Neck Surg 1991;117:1129-34. https://doi.org/10.1001/archotol.1991.01870220077013
  28. Park H, Park JS, Jeong WS, Choi JW. Dynamic hemitongue defect reconstruction with functional gracilis muscle free transfer. Ann Plast Surg 2021;86:308-16. https://doi.org/10.1097/SAP.0000000000002555
  29. Pribaz JJ, Chan RK. Where do perforator flaps fit in our armamentarium? Clin Plast Surg 2010;37:571-9. https://doi.org/10.1016/j.cps.2010.06.007
  30. Choi JW. Perforator flaps in head and neck reconstruction: a review article of "the current state of the art". Otorinolaringologia 2014;64:13-21.
  31. Chana JS, Odili J. Perforator flaps in head and neck reconstruction. Semin Plast Surg 2010;24:237-54. https://doi.org/10.1055/s-0030-1263066
  32. Wolff KD, Rau A, Kolk A. Perforator flaps from the lower leg for intraoral reconstruction: experience of 131 flaps. J Craniomaxillofac Surg 2018;46:338-45. https://doi.org/10.1016/j.jcms.2017.11.019
  33. Hung SY, Loh CY, Kwon SH, Tsai CH, Chang KP, Kao HK. Assessing the suitability of medial sural artery perforator flaps in tongue reconstruction: an outcome study. PLoS One 2017;12: e0171570. https://doi.org/10.1371/journal.pone.0171570
  34. Ali RS, Bluebond-Langner R, Rodriguez ED, Cheng MH. The versatility of the anterolateral thigh flap. Plast Reconstr Surg 2009;124(6 Suppl):e395-407. https://doi.org/10.1097/PRS.0b013e3181bcf05c
  35. Zhang PP, Meng L, Shen J, Liu H, Zhang J, Xiang X, et al. Free radial forearm flap and anterolateral thigh flap for reconstruction of hemiglossectomy defects: a comparison of quality of life. J Craniomaxillofac Surg 2018;46:2157-63. https://doi.org/10.1016/j.jcms.2018.10.006
  36. Choi JW, Kim YC, Oh TS, Koh KS, Jeong WS. The versatile use of revisited de-epithelialization concept in superficial circumflex iliac and anterolateral thigh perforator free flap for head and neck reconstructions. J Craniomaxillofac Surg 2017;45: 872-80. https://doi.org/10.1016/j.jcms.2017.02.010
  37. Choi JW, Nam SY, Choi SH, Roh JL, Kim SY, Hong JP. Applications of medial sural perforator free flap for head and neck reconstructions. J Reconstr Microsurg 2013;29:437-42. https://doi.org/10.1055/s-0033-1343959
  38. Largo RD, Bhadkamkar MA, Asaad M, Chu CK, Garvey PB, Butler CE, et al. The profunda artery perforator flap: a versatile option for head and neck reconstruction. Plast Reconstr Surg 2021;147:1401-12. https://doi.org/10.1097/PRS.0000000000007977
  39. Ferrari M, Sahovaler A, Chan HH, Nicolai P, Irish JC, Gilbert RW. Scapular tip-thoracodorsal artery perforator free flap for total/subtotal glossectomy defects: case series and conformance study. Oral Oncol 2020;105:104660. https://doi.org/10.1016/j.oraloncology.2020.104660
  40. Jain L, Kumta SM, Purohit SK, Raut R. Thoracodorsal artery perforator flap: indeed a versatile flap. Indian J Plast Surg 2015; 48:153-8. https://doi.org/10.4103/0970-0358.163051
  41. Ho AS, Kim S, Tighiouart M, Mita A, Scher KS, Epstein JB, et al. Quantitative survival impact of composite treatment delays in head and neck cancer. Cancer 2018;124:3154-62. https://doi.org/10.1002/cncr.31533
  42. Chepeha DB, Spector ME, Chinn SB, Casper KA, Chanowski EJ, Moyer JS, et al. Hemiglossectomy tongue reconstruction: modeling of elevation, protrusion, and functional outcome using receiver operator characteristic curve. Head Neck 2016;38: 1066-73. https://doi.org/10.1002/hed.24417
  43. Matsui Y, Ohno K, Yamashita Y, Takahashi K. Factors influencing postoperative speech function of tongue cancer patients following reconstruction with fasciocutaneous/myocutaneous flaps: a multicenter study. Int J Oral Maxillofac Surg 2007;36: 601-9. https://doi.org/10.1016/j.ijom.2007.01.014
  44. Uwiera T, Seikaly H, Rieger J, Chau J, Harris JR. Functional outcomes after hemiglossectomy and reconstruction with a bilobed radial forearm free flap. J Otolaryngol 2004;33:356-9. https://doi.org/10.2310/7070.2004.00356
  45. Jeong WS, Oh TS. Oral and oropharyngeal reconstruction with a free flap. Arch Craniofac Surg 2016;17:45-50. https://doi.org/10.7181/acfs.2016.17.2.45
  46. Ji YB, Cho YH, Song CM, Kim YH, Kim JT, Ahn HC, et al. Long-term functional outcomes after resection of tongue cancer: determining the optimal reconstruction method. Eur Arch Otorhinolaryngol 2017;274:3751-6. https://doi.org/10.1007/s00405-017-4683-8
  47. Bhattacharya S, Thankappan K, Joseph ST, Sukumaran SV, Shetty S, Mayadevi M, et al. Volume and location of the defect as predictors of swallowing outcome after glossectomy: correlation with a classification. Dysphagia 2021;36:974-83. https://doi.org/10.1007/s00455-020-10224-w
  48. Mannelli G, Arcuri F, Agostini T, Innocenti M, Raffaini M, Spinelli G. Classification of tongue cancer resection and treatment algorithm. J Surg Oncol 2018;117:1092-9. https://doi.org/10.1002/jso.24991
  49. Ansarin M, Bruschini R, Navach V, Giugliano G, Calabrese L, Chiesa F, et al. Classification of GLOSSECTOMIES: proposal for tongue cancer resections. Head Neck 2019;41:821-7. https://doi.org/10.1002/hed.25466
  50. Urken ML, Weinberg H, Vickery C, Buchbinder D, Lawson W, Biller HF. Oromandibular reconstruction using microvascular composite free flaps: report of 71 cases and a new classification scheme for bony, soft-tissue, and neurologic defects. Arch Otolaryngol Head Neck Surg 1991;117:733-44. https://doi.org/10.1001/archotol.1991.01870190045010
  51. Butler DP, Dunne JA, Wood SH, Jallali N. A unifying algorithm in microvascular reconstruction of oral cavity defects using the trilaminar concept. Plast Reconstr Surg Glob Open 2019;7:e2267. https://doi.org/10.1097/GOX.0000000000002267
  52. Liu WW, Zhang CY, Li JY, Zhang MF, Guo ZM. A novel classification system for the evaluation and reconstruction of oral defects following oncological surgery. Oncol Lett 2017;14: 7049-54.
  53. de Almeida JR, Park RC, Villanueva NL, Miles BA, Teng MS, Genden EM. Reconstructive algorithm and classification system for transoral oropharyngeal defects. Head Neck 2014;36: 934-41. https://doi.org/10.1002/hed.23353
  54. Kimata Y, Sakuraba M, Hishinuma S, Ebihara S, Hayashi R, Asakage T, et al. Analysis of the relations between the shape of the reconstructed tongue and postoperative functions after subtotal or total glossectomy. Laryngoscope 2003;113:905-9. https://doi.org/10.1097/00005537-200305000-00024
  55. Yun IS, Lee DW, Lee WJ, Lew DH, Choi EC, Rah DK. Correlation of neotongue volume changes with functional outcomes after long-term follow-up of total glossectomy. J Craniofac Surg 2010;21:111-6. https://doi.org/10.1097/SCS.0b013e3181c46692
  56. Cho KJ, Joo YH, Sun DI, Kim MS. Perioperative clinical factors affecting volume changes of reconstructed flaps in head and neck cancer patients: free versus regional flaps. Eur Arch Otorhinolaryngol 2011;268:1061-5. https://doi.org/10.1007/s00405-010-1450-5
  57. Tarsitano A, Battaglia S, Cipriani R, Marchetti C. Microvascular reconstruction of the tongue using a free anterolateral thigh flap: three-dimensional evaluation of volume loss after radiotherapy. J Craniomaxillofac Surg 2016;44:1287-91. https://doi.org/10.1016/j.jcms.2016.04.031
  58. Bittermann G, Thonissen P, Poxleitner P, Zimmerer R, Vach K, Metzger MC. Microvascular transplants in head and neck reconstruction: 3D evaluation of volume loss. J Craniomaxillofac Surg 2015;43:1319-24. https://doi.org/10.1016/j.jcms.2015.06.013
  59. Stone M, Woo J, Lee J, Poole T, Seagraves A, Chung M, et al. Structure and variability in human tongue muscle anatomy. Comput Methods Biomech Biomed Eng Imaging Vis 2018;6: 499-507. https://doi.org/10.1080/21681163.2016.1162752
  60. Stone M. Tongue muscle anatomy: architecture and function [Internet]. London: Oxford Research Encyclopedia of Linguistics; c2020 [cited 2022 May 9]. Available from: https://doi.org/10.1093/acrefore/9780199384655.013.418.
  61. Yamamoto Y, Sugihara T, Furuta Y, Fukuda S. Functional reconstruction of the tongue and deglutition muscles following extensive resection of tongue cancer. Plast Reconstr Surg 1998;102:993-1000. https://doi.org/10.1097/00006534-199809040-00009
  62. Riva G, Sapino S, Ravera M, Elia G, Pecorari G. Long-term functional outcomes and quality of life after partial glossectomy for T2 squamous cell carcinomas. Braz J Otorhinolaryngol 2021 Jul 30 [Epub]. https://doi.org/10.1016/j.bjorl.2021.06.009.
  63. Dziegielewski PT, Ho ML, Rieger J, Singh P, Langille M, Harris JR, et al. Total glossectomy with laryngeal preservation and free flap reconstruction: objective functional outcomes and systematic review of the literature. Laryngoscope 2013;123: 140-5. https://doi.org/10.1002/lary.23505
  64. Matsui Y, Shirota T, Yamashita Y, Ohno K. Analyses of speech intelligibility in patients after glossectomy and reconstruction with fasciocutaneous/myocutaneous flaps. Int J Oral Maxillofac Surg 2009;38:339-45. https://doi.org/10.1016/j.ijom.2009.01.009
  65. Sun J, Weng Y, Li J, Wang G, Zhang Z. Analysis of determinants on speech function after glossectomy. J Oral Maxillofac Surg 2007;65:1944-50. https://doi.org/10.1016/j.joms.2006.11.017
  66. Lam L, Samman N. Speech and swallowing following tongue cancer surgery and free flap reconstruction: a systematic review. Oral Oncol 2013;49:507-24. https://doi.org/10.1016/j.oraloncology.2013.03.001
  67. Shin YS, Koh YW, Kim SH, Jeong JH, Ahn S, Hong HJ, et al. Radiotherapy deteriorates postoperative functional outcome after partial glossectomy with free flap reconstruction. J Oral Maxillofac Surg 2012;70:216-20. https://doi.org/10.1016/j.joms.2011.04.014
  68. Yi CR, Jeong WS, Oh TS, Koh KS, Choi JW. Analysis of speech and functional outcomes in tongue reconstruction after hemiglossectomy. J Reconstr Microsurg 2020;36:507-13. https://doi.org/10.1055/s-0040-1709493
  69. Ravindra A, Nayak DR, Devaraja K, Matthew NM, Tiwari S. Functional outcomes after surgical resection of tongue cancer; a comparative study between primary closure, secondary intention healing and flap reconstruction. Indian J Otolaryngol Head Neck Surg 2022 Jan 5 [Epub]. https://doi.org/10.1007/ s12070-021-03038-1.
  70. Rui X, Huang Z, Zuo J, Wang Y, Liang Q, Jin T, et al. Application of an L-shaped anterolateral thigh flap in reconstruction after hemiglossectomy. BMC Surg 2022;22:32. https://doi.org/10.1186/s12893-022-01473-7
  71. Fan S, Li QX, Zhang HQ, Liang MJ, Tian T, Wang YY, et al. "Five-point eight-line" anatomic flap design for precise hemitongue reconstruction. Head Neck 2019;41:1359-66. https://doi.org/10.1002/hed.25571
  72. Choi JW, Lee MY, Oh TS. The application of multilobed flap designs for anatomic and functional oropharyngeal reconstructions. J Craniofac Surg 2013;24:2091-7. https://doi.org/10.1097/SCS.0b013e3182a2442c
  73. Brown L, Rieger JM, Harris J, Seikaly H. A longitudinal study of functional outcomes after surgical resection and microvascular reconstruction for oral cancer: tongue mobility and swallowing function. J Oral Maxillofac Surg 2010;68:2690-700. https://doi.org/10.1016/j.joms.2010.05.004
  74. Rieger JM, Zalmanowitz JG, Li SY, Sytsanko A, Harris J, Williams D, et al. Functional outcomes after surgical reconstruction of the base of tongue using the radial forearm free flap in patients with oropharyngeal carcinoma. Head Neck 2007;29: 1024-32. https://doi.org/10.1002/hed.20623
  75. Yanai C, Kikutani T, Adachi M, Thoren H, Suzuki M, Iizuka T. Functional outcome after total and subtotal glossectomy with free flap reconstruction. Head Neck 2008;30:909-18. https://doi.org/10.1002/hed.20804
  76. Fujimoto Y, Matsuura H, Kawabata K, Takahashi K, Tayama N. Assessment of Swallowing Ability Scale for oral and oropharyngeal cancer patients. Nihon Jibiinkoka Gakkai Kaiho 1997; 100:1401-7. https://doi.org/10.3950/jibiinkoka.100.1401
  77. Pedersen A, Wilson J, McColl E, Carding P, Patterson J. Swallowing outcome measures in head and neck cancer: how do they compare? Oral Oncol 2016;52:104-8. https://doi.org/10.1016/j.oraloncology.2015.10.015
  78. Thankappan K, Kuriakose MA, Chatni SS, Sharan R, Trivedi NP, Vijayaraghavan S, et al. Lateral arm free flap for oral tongue reconstruction: an analysis of surgical details, morbidity, and functional and aesthetic outcome. Ann Plast Surg 2011;66:261-6. https://doi.org/10.1097/SAP.0b013e3181d50e9e
  79. Chang EI, Yu P, Skoracki RJ, Liu J, Hanasono MM. Comprehensive analysis of functional outcomes and survival after microvascular reconstruction of glossectomy defects. Ann Surg Oncol 2015;22:3061-9. https://doi.org/10.1245/s10434-015-4386-6