Yousif N J, Dzwierzynski W W, Sanger J R, Matloub H S, Campbell B H
Aesthetic and Reconstructive Surgery Associates, Brookfield, Department of Plastic and Reconstructive Surgery, Medical College of Wisconsin, Milwaukee 53226, USA.
Plast Reconstr Surg. 1999 Sep;104(4):916-21. doi: 10.1097/00006534-199909040-00004.
A functional neotongue following total glossectomy requires both soft-tissue bulk and reconstruction of muscle function. We used innervated transverse gracilis musculocutaneous flaps to reconstruct total glossectomy defects in eight patients. The obturator nerve to the gracilis muscle was approximated to the hypoglossal nerve to reinnervate the gracilis muscle by using microsurgical technique. The cutaneous paddle of the gracilis flap easily supplies sufficient bulk to replace the total glossectomy defect. Follow-up of patients ranged from 3 to 47 months. All patients were able to resume oral feeding. Electromyographic studies performed on one patient showed reinnervation of the flap with active elevation of the posterior pharynx. Ultimately, seven patients died because of recurrence of their disease. The innervated gracilis musculocutaneous flap may benefit patients who have a total glossectomy by allowing them to achieve a more functional recovery.
全舌切除术后的功能性新舌需要软组织体积和肌肉功能重建。我们使用带神经的股薄肌肌皮瓣修复8例患者的全舌切除术后缺损。采用显微外科技术将股薄肌的闭孔神经与舌下神经吻合，以重新支配股薄肌。股薄肌瓣的皮瓣很容易提供足够的组织量来替代全舌切除术后的缺损。患者随访时间为3至47个月。所有患者均能恢复经口进食。对1例患者进行的肌电图研究显示皮瓣重新获得神经支配，咽后壁有主动抬高。最终，7例患者因疾病复发死亡。带神经的股薄肌肌皮瓣可能使全舌切除术后的患者受益，使其获得更好的功能恢复。
