Tongue flaps: repair of oral and pharyngeal defects after resection for cancer.

During the past 15 years, well over 100 major tongue flaps have been used in reconstruction in patients with head and neck cancer at the Mayo Clinic and the Mason Clinic. Although the trend at the present time is toward utilization of smaller flaps of local tissue, as described elsewhere, in an effort to achieve primary closure with the least possible functional disability, the tongue flap still retains its initial advantages of providing tissue bulk and volume, dependable vascularity, and considerable versatility in design and application. While the use of myocutaneous flaps and other single stage methods of repair is becoming ever more popular, the tongue flap should not be discarded or forgotten as a significant tool for use by the head and neck cancer surgeon.