ALT Flap with Motor and Sensorial Innervation for Functional Reconstruction of the Tongue

OBJECTIVE:

The purpose of this study is to report the motor functional outcomes and sensory recovery of patients who had undergone total or subtotal glossectomy for oral carcinomas, reconstructed with chimeric anterolateral thigh (ALT) flaps.

METHODS:

Five patients (all men), with a mean age of 49.5 years (range, 36-73 years) were included in the study. All patients were treated with chimeric ALT, including the vastus lateralis muscle with its motor nerve, and skin paddle with its innervating nerve. All patients underwent functional tests involving sensory recovery, intelligibility, and swallowing.

RESULTS:

Mean follow-up was 26.6 months (12 months-5 years). The flaps were successful in all 5 patients. The donor site was closed primarily, and no complications were seen in the follow-up period. Normal extension of the knee joint and no evidence of lateral patella instability occurred. Speech intelligibility was good in 3 patients and acceptable in 2. Deglutition scores were 6 in 2 patients, 5 in 2, and 4 in 1. All sensory tests were satisfactory in all parameters.

CONCLUSIONS:

The results of this reconstructive option were satisfactory in terms of motor function and sensitive assessment of the neotongue. This technique is strongly recommended for patients with total or subtotal glossectomy.

Keywords: ALT flap, microsurgery, tongue reconstruction, glossectomy, innervation