Prosthetic Management of Flap-Related Complications Following Glossectomy in Locally Advanced Tongue Cancer

• Published in: Indian journal of plastic surgery Vol. 56; no. 4; pp. 382 - 385
• Main Authors: Jagtiani, Kiran, Bhatia, Prachi, Jain, Radhika, Singh, Gurkaran Preet, Gurav, Sandeep
• Format: Journal Article
• Language: English
• Published: A-12, 2nd Floor, Sector 2, Noida-201301 UP, India Thieme Medical and Scientific Publishers Pvt. Ltd 01-08-2023; Thieme Medical Publishers, Inc
• Subjects: Case Series; free flap; obturator; postoperative complications; tongue reconstruction
• ISSN: 0970-0358; 1998-376X
• DOI: 10.1055/s-0043-1772455

Abstract
Total glossectomy defects resulting from postoncologic resection are commonly reconstructed with locoregional or free flaps. However, effectively managing complications that may arise after reconstruction can be a significant challenge. We present a unique case series describing prosthetic management of flap-related complications following glossectomy in patients treated for locally advanced tongue cancer. Three patients underwent total glossectomy, neck dissection, reconstruction using free flap, and tracheostomy. Two patients developed an intraoral fistula located in the anterior region of the floor of the mouth. The third patient developed a flap failure requiring a second procedure using a pectoralis major myocutaneous flap for correction of the orocutaneous fistula that ultimately did not heal. Mandibular obturator prostheses lined with a soft liner were fabricated for all the patients, which helped reduce salivary incontinence and improve swallowing and speech. This case series highlights that a collaborative interdisciplinary team approach is crucial for optimizing postoperative function and outcomes when managing complications from reconstructive procedures.