Microneurovascular transfer of the tensor fascia lata musculocutaneous flap for reconstruction of the tongue.

The tensor fascia lata musculocutaneous flap has been successfully transferred for coverage of the groin, abdomen, and thigh regions. After free transfer, it has demonstrated both muscle reinnervation and sensibility. The current study presents anatomical dissections and five clinical cases of innervated tensor fascia lata musculocutaneous flap transfer for immediate reconstruction of subtotal glossectomy defects after carcinoma extirpation. Clinical evaluation 10 to 24 months postoperatively with oral pressure measurement, electromyography, cineradiography, and speech analysis demonstrated adequate bulk and both sensory and motor function. Speech and swallowing were superior to those in patients whose defects were repaired by primary closure and pectoralis major musculocutaneous flaps. Tensor fascia lata reconstructions showed superior tongue-palate and tongue-pharynx contact and improved oral functional rehabilitation. We believe the tensor fascia lata musculocutaneous flap is ideal for reconstruction of total or partial glossectomy defects because of its appropriate bulk and reinnervation.