Tongue pressure in patients with tongue cancer resection and reconstruction.

OBJECTIVE: Assessment of tongue function following tongue reconstruction is important to evaluate patient status. To assess tongue function in patients who had undergone tongue reconstruction, the surgical team used a simple, hand-held tongue pressure measurement device to measure tongue power. METHODS: Tongue power of 30 patients (25 males, 5 females; average age: 53.6±15.0 years) was calculated using a hand-held tongue pressure measurement device, six months postoperation. The defects were classified into minimal glossectomy (MG) (n=8), near-half partial glossectomy of the mobile tongue (PG) (n=5), hemi-glossectomy (HG) (n=4), more than half partial glossectomy of the mobile tongue (SG-MT) (n=7), and subtotal glossectomy (SG) (n=6). As seen in other tongue assessments, a simple articulatory test, food evaluation, and speech intelligibility assessment were also performed; resulting correlations were statistically calculated using tongue pressure values. RESULTS: The tongue pressure values were 94.0±14.5% in MG, 48.5±13.2(a) % in PG, 40.4±18.7(a) % in HG, 19.3±7.7(a,b) % in SG-MT, and 15.3±5.6(a,b) % in SG (a: <0.05 vs. MG, b: <0.05 vs. PG). The Pearson r was 0.77, 0.67, and 0.74 when correlated with simple articulatory test, food evaluation, and speech intelligibility assessment, respectively. CONCLUSION: Tongue pressure measurement in patients with tongue cancer resection and reconstruction facilitated determination of patients' tongue function status.

A new nasal cavity and maxilla reconstruction method using jejunum flap with non-vascularised bone.

Reconstruction of the midface is still challenging for reconstructive surgeons because of its complex structure and the need for an aesthetic result. We used a free jejunum flap for the nasal cavity and non-vascularised bone covered by the jejunal seromuscular patch for the facial bone structure. One patient who had a midface defect received reconstructive surgery using free jejunum flap with non-vascularised bone. The nasal cavity reconstruction using jejunal mucosa was moisturised and had less crust formation. The nasal cavity space was very large and patients could breathe easily via the nose. The non-vascularised bone covered by the jejunal seromuscular patch did not dry out or become less absorbent. The reconstruction of the nasal cavity and maxilla using free jejunum flap with non-vascularised bone is novel and useful in some surgical cases.