Reconstruction of the tongue.

Subtotal or total glossectomies performed for malignancies or other afflictions of the tongue are fraught with great disabling problems postoperatively. Recently the introduction of myocutaneous flaps has aroused new interest in surgical procedures to reconstruct the tongue following major resections. A new approach to functional reconstruction of the tongue is presented utilizing the sternocleidomastoid myocutaneous flap based superiorly. Neurorrhaphy between the hypoglossal nerve on the resected side of the tongue and the nerve to the sternocleidomastoid muscle is easily achieved without under tension as these nerves are in close proximity. In addition, the sternocleidomastoid myocutaneous flap is an ideal flap in tongue reconstruction as there is no fat between the skin and muscle and it resembles the bulkiness of the tongue muscle itself. A patient with a carcinoma of the tongue treated with subtotal resection and reconstruction using the above principles demonstrated full tongue movements 11 months postoperatively.