Tongue flap- a good choice for intraoral reconstruction after marginal mandibulectomy: a single institution retrospective study of 27 cases

Abstract

Background: Marginal mandibulectomy with wide excision of the primary tumour in the treatment of the oral cavity squamous cell cancers preserves the form and function of the mandible, without compromise in obtaining oncologically safe margins. Of the various methods of reconstruction of the composite intraoral tissue defect, tongue flaps offer an easy and effective method of reconstruction.

Methods: We have collected the records of 27 patients who underwent marginal mandibulectomy and tongue flap reconstruction in the last 6 years from the cancer department master case sheets, operative records and follow up records. The information on the immediate and long term complications were obtained from the records and functional outcomes of patients were recorded at the time of last follow up and analysed. All the 27 patients had horizontal marginal mandibulectomy with an anteriorly or posteriorly based tongue flap reconstruction.  

Results: The most common early postoperative complication was infection around the flap site that occurred in 18.5% of patients. The other complications including haemorrhage, flap dehiscence occurred in few patients which were managed effectively. There was no incidence of major flap necrosis. Speech and swallowing difficulty was encountered in 18.5% and 14.8% of patients respectively. The long term complications were managed conservatively with speech and swallowing therapy.

Conclusions:In our experience, tongue is an excellent donor site for intraoral soft tissue reconstruction, providing an analogous tissue for reconstruction. The technique is simple with acceptable rates of immediate and long term complications and with good functional outcomes.