Scapular tip-thoracodorsal artery perforator free flap for total/subtotal glossectomy defects: Case series and conformance study.
Conformance
Defect
Free flap
Oral cancer
Scapula
Speech
Subtotal glossectomy
Swallowing
Thoracodorsal artery
Total glossectomy
Journal
Oral oncology
ISSN: 1879-0593
Titre abrégé: Oral Oncol
Pays: England
ID NLM: 9709118
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
12
11
2019
revised:
08
03
2020
accepted:
18
03
2020
pubmed:
3
4
2020
medline:
17
2
2021
entrez:
3
4
2020
Statut:
ppublish
Résumé
Reconstruction of the tongue and floor of mouth after total/subtotal glossectomy poses a major challenge for reconstructive surgeons. Speech and deglutition after total glossectomy are usually significantly impaired, affecting the quality of life of these patients. Maintaining an adequate volume of the reconstruction is paramount to optimize speech and swallowing function postoperatively. To report a novel free flap reconstructive technique based on the subscapular system. A preliminary cases series of patients undergoing reconstruction with scapular tip-thoracodorsal artery perforator (STTDAP) flap after total/subtotal glossectomy is reported. Conformance of the scapular tip with respect to the inner aspect of the mandible is measured in a sample of 10 subjects (20 sides) with normal scapular and mandibular anatomy, considering both the entirety of the scapular tip (overall conformance) and its caudal border (border conformance). Association between scapular morphology and conformance to the mandible was assessed statistically. Three patients matched inclusion criteria. Mean follow-up was 7 months. Speech and deglutition result was satisfactory in 2 patients and poor in 1 patient. Overall and border conformance were high (root mean square: 2.23 mm and 3.14 mm, respectively). Shape and angular aperture of the scapular tip significantly affected overall and border conformance, respectively. Reconstruction of the tongue with STTDAP flap after total glossectomy is feasible. Conformance between the scapular tip and mandible is optimal and, although based on preliminary evidence, patients might benefit from this technique in terms of functional outcomes.
Sections du résumé
BACKGROUND
Reconstruction of the tongue and floor of mouth after total/subtotal glossectomy poses a major challenge for reconstructive surgeons. Speech and deglutition after total glossectomy are usually significantly impaired, affecting the quality of life of these patients. Maintaining an adequate volume of the reconstruction is paramount to optimize speech and swallowing function postoperatively.
AIM
To report a novel free flap reconstructive technique based on the subscapular system.
METHODS
A preliminary cases series of patients undergoing reconstruction with scapular tip-thoracodorsal artery perforator (STTDAP) flap after total/subtotal glossectomy is reported. Conformance of the scapular tip with respect to the inner aspect of the mandible is measured in a sample of 10 subjects (20 sides) with normal scapular and mandibular anatomy, considering both the entirety of the scapular tip (overall conformance) and its caudal border (border conformance). Association between scapular morphology and conformance to the mandible was assessed statistically.
RESULTS
Three patients matched inclusion criteria. Mean follow-up was 7 months. Speech and deglutition result was satisfactory in 2 patients and poor in 1 patient. Overall and border conformance were high (root mean square: 2.23 mm and 3.14 mm, respectively). Shape and angular aperture of the scapular tip significantly affected overall and border conformance, respectively.
CONCLUSION
Reconstruction of the tongue with STTDAP flap after total glossectomy is feasible. Conformance between the scapular tip and mandible is optimal and, although based on preliminary evidence, patients might benefit from this technique in terms of functional outcomes.
Identifiants
pubmed: 32240930
pii: S1368-8375(20)30096-8
doi: 10.1016/j.oraloncology.2020.104660
pii:
doi:
Types de publication
Case Reports
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
104660Informations de copyright
Copyright © 2020. Published by Elsevier Ltd.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.