A new bilobed design for the sensate radial forearm flap to preserve tongue mobility following significant glossectomy.

OBJECTIVE

A new bilobed design of the sensate radial forearm flap is presented for reconstruction of the oral cavity following significant glossectomy. One lobe of the flap is used to restore the shape and volume of the tongue, while the second lobe is used to resurface the floor of the mouth and the gingiva.

SETTING

Tertiary referral center.

PATIENTS

Ten patients who underwent significant glossectomy for squamous cell cancer were included in this study. Patients were deemed candidates for this form of reconstruction when at least one half of the mobile tongue was resected and the residual tongue had an intact motor nerve supply.

RESULTS

In addition to the thin, pliable, and sensate tissue of the radial forearm skin, the bilobed design helps to prevent tethering of the root of the tongue to the inner table of the mandible. This factor is felt to be important in maximizing the mobility of the residual tongue. There were no flap failures or partial necroses. Tongue mobility, oral alimentation, articulation, and return of sensation are described.