TY - JOUR
T1 - Use of the myocutaneous serratus anterior free flap for reconstruction after salvage glossectomy
AU - Janik, Stefan
AU - Pyka, Julian
AU - Stanisz, Isabella
AU - Wachholbinger, Tamara
AU - Leonhard, Matthias
AU - Roesner, Imme
AU - Denk-Linnert, Doris Maria
AU - Miles, Brett A.
AU - Schneider-Stickler, Berit
AU - Erovic, Boban M.
N1 - Funding Information:
Open access funding provided by Medical University of Vienna.
Publisher Copyright:
© 2018, The Author(s).
PY - 2019/2/14
Y1 - 2019/2/14
N2 - Purpose: To describe the use of a myocutaneous serratus anterior free flap (SAFF) for tongue reconstruction after salvage subtotal (STG) and total glossectomy (TG). Methods: In this prospective case series, seven patients underwent salvage STG or TG and reconstruction with a myocutaneous SAFF between 10/2015 and 02/2017. Functional and oncologic outcomes were prospectively evaluated. Donor side morbidity was determined using the Disabilities of the Arm, Shoulder and Hand (DASH) score. Results: SAFF with mean skin paddles of 6.7 cm × 8.7 cm was used in five STG and two TG patients, respectively. There was a 100% flap survival and a mean DASH score of 10.8 reflected normal arm and shoulder function after surgery. One year after salvage surgery, 1 (14.3%) and 4 (57.1%) patients were tracheostomy and gastrostomy tube dependent. Gastrostomy tube dependence was significantly worse in patients with tumors of the base of tongue compared to other tumor sites (p = 0.030) and in patients who underwent transcervical compared to transoral tumor resection (p = 0.008). Local recurrence rate was 57.1% with a disease-free survival of 17.6 months. Conclusion: The myocutaneous SAFF represents a safe and reliable flap for tongue reconstruction after salvage glossectomy with satisfying functional outcomes and low donor side morbidity.
AB - Purpose: To describe the use of a myocutaneous serratus anterior free flap (SAFF) for tongue reconstruction after salvage subtotal (STG) and total glossectomy (TG). Methods: In this prospective case series, seven patients underwent salvage STG or TG and reconstruction with a myocutaneous SAFF between 10/2015 and 02/2017. Functional and oncologic outcomes were prospectively evaluated. Donor side morbidity was determined using the Disabilities of the Arm, Shoulder and Hand (DASH) score. Results: SAFF with mean skin paddles of 6.7 cm × 8.7 cm was used in five STG and two TG patients, respectively. There was a 100% flap survival and a mean DASH score of 10.8 reflected normal arm and shoulder function after surgery. One year after salvage surgery, 1 (14.3%) and 4 (57.1%) patients were tracheostomy and gastrostomy tube dependent. Gastrostomy tube dependence was significantly worse in patients with tumors of the base of tongue compared to other tumor sites (p = 0.030) and in patients who underwent transcervical compared to transoral tumor resection (p = 0.008). Local recurrence rate was 57.1% with a disease-free survival of 17.6 months. Conclusion: The myocutaneous SAFF represents a safe and reliable flap for tongue reconstruction after salvage glossectomy with satisfying functional outcomes and low donor side morbidity.
KW - Functional outcomes
KW - Myocutaneous SAFF
KW - Salvage glossectomy
KW - Subtotal glossectomy
KW - Total glossectomy
UR - http://www.scopus.com/inward/record.url?scp=85058478545&partnerID=8YFLogxK
U2 - 10.1007/s00405-018-5245-4
DO - 10.1007/s00405-018-5245-4
M3 - Article
C2 - 30552516
AN - SCOPUS:85058478545
SN - 0937-4477
VL - 276
SP - 559
EP - 566
JO - European Archives of Oto-Rhino-Laryngology
JF - European Archives of Oto-Rhino-Laryngology
IS - 2
ER -