Reinnervated anterolateral thigh flap for tongue reconstruction.

Abstract

Total or near-total glossectomy defects are commonly reconstructed with rectus abdominis myocutaneous flaps for coverage. Sensory reinnervation has rarely been performed. Thirteen consecutive total or near-total glossectomy reconstructions were performed in a 12-month period with anterolateral thigh flaps with (n = 8) or without (n = 5) sensory reinnervation to the lingual nerve. Two-point discrimination, Semmes-Weinstein monofilament testing, pain, and temperature testing were performed before and after 12 months of surgery. Speech and swallow functions were assessed with an established grading system. Innervated flaps had superior sensory recovery to noninnervated flaps in all testing modalities. Postoperative radiotherapy may delay sensory recovery. Swallow function was better in the innervated group. Return of sensation also improves overall patient satisfaction. The reinnervated anterolateral thigh flap is a viable option to reconstruct total or near-total glossectomy defects with good speech and swallow functions.