A novel anatomy-based five-points eight-line-segments technique for precision subtotal tongue reconstruction: A pilot study

•FIPELS flap was arisen from virtual dissection of the subtotal tongue.•FIPELS technique could provide a natural-shape subtotal tongue contour.•Functional and cosmetic outcomes are significantly improved by FIPELS technique. A no-flap design based on actual tongue anatomy has been reported to achiev...

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Published in:Oral oncology 2019-02, Vol.89, p.1-7
Main Authors: Fan, Song, Zhang, Hanqing, Li, Qunxing, Liang, Faya, Bai, Zhiqiang, Chen, Weixiong, Sun, Sheng, Yu, Peirong, Li, Jinsong
Format: Article
Language:English
Subjects:
Adult
Aged
Anterolateral thigh flap
Female
Five-points eight-line-segments
Humans
Male
Middle Aged
Nerve coaptation
Pilot Projects
Reconstructive Surgical Procedures - methods
Subtotal tongue reconstruction
Tongue - pathology
Tongue - surgery
Tongue cancer
Tongue Neoplasms - surgery
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cited_by cdi_FETCH-LOGICAL-c380t-9432916af8997bdc31fd96f6792c4a3773f881973800ebdf0ce3415ad9a2937c3
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container_issue
container_start_page 1
container_title Oral oncology
container_volume 89
creator Fan, Song
Zhang, Hanqing
Li, Qunxing
Liang, Faya
Bai, Zhiqiang
Chen, Weixiong
Sun, Sheng
Yu, Peirong
Li, Jinsong
description •FIPELS flap was arisen from virtual dissection of the subtotal tongue.•FIPELS technique could provide a natural-shape subtotal tongue contour.•Functional and cosmetic outcomes are significantly improved by FIPELS technique. A no-flap design based on actual tongue anatomy has been reported to achieve precise reconstruction, but large carcinologic tongue defects remain extremely challenging to treat. The aim of this pilot study was to explore an anatomy-based flap design for precision subtotal tongue reconstruction. Thirty-five patients were randomly divided into two groups, a “five-points eight-line-segments” (FIPELS) technique flap design group (18 patients) and a conventional surgery group (17 patients), to undergo subtotal tongue reconstruction. All patients received an anterolateral thigh flap with nerve coaptation to the lingual or glossopharyngeal nerve. Swallowing function, speech intelligibility, and cosmetic results were assessed with a Likert scale, and epicritic and proprioceptive sensitivity and thermosensation of the neotongue were investigated. Outcomes were analyzed, and a p-value 
doi_str_mv 10.1016/j.oraloncology.2018.12.004
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A no-flap design based on actual tongue anatomy has been reported to achieve precise reconstruction, but large carcinologic tongue defects remain extremely challenging to treat. The aim of this pilot study was to explore an anatomy-based flap design for precision subtotal tongue reconstruction. Thirty-five patients were randomly divided into two groups, a “five-points eight-line-segments” (FIPELS) technique flap design group (18 patients) and a conventional surgery group (17 patients), to undergo subtotal tongue reconstruction. All patients received an anterolateral thigh flap with nerve coaptation to the lingual or glossopharyngeal nerve. Swallowing function, speech intelligibility, and cosmetic results were assessed with a Likert scale, and epicritic and proprioceptive sensitivity and thermosensation of the neotongue were investigated. Outcomes were analyzed, and a p-value &lt; 0.05 was considered significant. The FIPELS flaps were significantly larger than conventionally designed flaps. All flaps healed uneventfully, except in two patients who presented with partial necrosis. Relative to patients in the conventional group, patients in the FIPELS group showed significantly improved swallowing function (p = 0.043) and cosmetic results (p = 0.017) but not speech intelligibility (p = 0.154). Patients in the two groups recovered comparably in terms of epicritic and proprioceptive sensitivity and thermosensation. The anatomy-based FIPELS technique is an innovative and effective solution for subtotal tongue reconstruction.</description><identifier>ISSN: 1368-8375</identifier><identifier>EISSN: 1879-0593</identifier><identifier>DOI: 10.1016/j.oraloncology.2018.12.004</identifier><identifier>PMID: 30732945</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Anterolateral thigh flap ; Female ; Five-points eight-line-segments ; Humans ; Male ; Middle Aged ; Nerve coaptation ; Pilot Projects ; Reconstructive Surgical Procedures - methods ; Subtotal tongue reconstruction ; Tongue - pathology ; Tongue - surgery ; Tongue cancer ; Tongue Neoplasms - surgery</subject><ispartof>Oral oncology, 2019-02, Vol.89, p.1-7</ispartof><rights>2018 Elsevier Ltd</rights><rights>Copyright © 2018 Elsevier Ltd. 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A no-flap design based on actual tongue anatomy has been reported to achieve precise reconstruction, but large carcinologic tongue defects remain extremely challenging to treat. The aim of this pilot study was to explore an anatomy-based flap design for precision subtotal tongue reconstruction. Thirty-five patients were randomly divided into two groups, a “five-points eight-line-segments” (FIPELS) technique flap design group (18 patients) and a conventional surgery group (17 patients), to undergo subtotal tongue reconstruction. All patients received an anterolateral thigh flap with nerve coaptation to the lingual or glossopharyngeal nerve. Swallowing function, speech intelligibility, and cosmetic results were assessed with a Likert scale, and epicritic and proprioceptive sensitivity and thermosensation of the neotongue were investigated. Outcomes were analyzed, and a p-value &lt; 0.05 was considered significant. The FIPELS flaps were significantly larger than conventionally designed flaps. All flaps healed uneventfully, except in two patients who presented with partial necrosis. Relative to patients in the conventional group, patients in the FIPELS group showed significantly improved swallowing function (p = 0.043) and cosmetic results (p = 0.017) but not speech intelligibility (p = 0.154). Patients in the two groups recovered comparably in terms of epicritic and proprioceptive sensitivity and thermosensation. The anatomy-based FIPELS technique is an innovative and effective solution for subtotal tongue reconstruction.</description><subject>Adult</subject><subject>Aged</subject><subject>Anterolateral thigh flap</subject><subject>Female</subject><subject>Five-points eight-line-segments</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nerve coaptation</subject><subject>Pilot Projects</subject><subject>Reconstructive Surgical Procedures - methods</subject><subject>Subtotal tongue reconstruction</subject><subject>Tongue - pathology</subject><subject>Tongue - surgery</subject><subject>Tongue cancer</subject><subject>Tongue Neoplasms - surgery</subject><issn>1368-8375</issn><issn>1879-0593</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqNkE2PFCEQhjtG466rf8EQT15o-ehuYG-TXb-STbzomdBQPcukG1qgJ5n452Uyq_HoCcL7FFX1NM07SlpK6PDh0MZk5hhsnOP-1DJCZUtZS0j3rLmmUihMesWf1zsfJJZc9FfNq5wPhJCe9uRlc8WJ4Ex1_XXza4dCPMKMTDAlLic8mgwOTf4IeI0-lIzA7x8Lnn0AnGG_wPmtgH0M_ucGaIoJrQmszz4GlLexxGJmVGLY17QGMeSSNltqfIt2aPVzLCiXzZ1eNy8mM2d483TeND8-ffx-9wU_fPv89W73gC2XpGDV1VnpYCaplBid5XRyapgGoZjtDBeCT1JSJSpMYHQTscA72hunDFNcWH7TvL_8u6ZYR85FLz5bmGcTIG5ZM8YUUV0nSUVvL6hNMecEk16TX0w6aUr0Wb4-6H_l67N8TZmu8mvx26c-27iA-1v6x3YF7i8A1G2PHpLO1kOw4HwVVbSL_n_6_AbimJ-l</recordid><startdate>201902</startdate><enddate>201902</enddate><creator>Fan, Song</creator><creator>Zhang, Hanqing</creator><creator>Li, Qunxing</creator><creator>Liang, Faya</creator><creator>Bai, Zhiqiang</creator><creator>Chen, Weixiong</creator><creator>Sun, Sheng</creator><creator>Yu, Peirong</creator><creator>Li, Jinsong</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201902</creationdate><title>A novel anatomy-based five-points eight-line-segments technique for precision subtotal tongue reconstruction: A pilot study</title><author>Fan, Song ; Zhang, Hanqing ; Li, Qunxing ; Liang, Faya ; Bai, Zhiqiang ; Chen, Weixiong ; Sun, Sheng ; Yu, Peirong ; Li, Jinsong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c380t-9432916af8997bdc31fd96f6792c4a3773f881973800ebdf0ce3415ad9a2937c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anterolateral thigh flap</topic><topic>Female</topic><topic>Five-points eight-line-segments</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nerve coaptation</topic><topic>Pilot Projects</topic><topic>Reconstructive Surgical Procedures - methods</topic><topic>Subtotal tongue reconstruction</topic><topic>Tongue - pathology</topic><topic>Tongue - surgery</topic><topic>Tongue cancer</topic><topic>Tongue Neoplasms - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fan, Song</creatorcontrib><creatorcontrib>Zhang, Hanqing</creatorcontrib><creatorcontrib>Li, Qunxing</creatorcontrib><creatorcontrib>Liang, Faya</creatorcontrib><creatorcontrib>Bai, Zhiqiang</creatorcontrib><creatorcontrib>Chen, Weixiong</creatorcontrib><creatorcontrib>Sun, Sheng</creatorcontrib><creatorcontrib>Yu, Peirong</creatorcontrib><creatorcontrib>Li, Jinsong</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Oral oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fan, Song</au><au>Zhang, Hanqing</au><au>Li, Qunxing</au><au>Liang, Faya</au><au>Bai, Zhiqiang</au><au>Chen, Weixiong</au><au>Sun, Sheng</au><au>Yu, Peirong</au><au>Li, Jinsong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A novel anatomy-based five-points eight-line-segments technique for precision subtotal tongue reconstruction: A pilot study</atitle><jtitle>Oral oncology</jtitle><addtitle>Oral Oncol</addtitle><date>2019-02</date><risdate>2019</risdate><volume>89</volume><spage>1</spage><epage>7</epage><pages>1-7</pages><issn>1368-8375</issn><eissn>1879-0593</eissn><abstract>•FIPELS flap was arisen from virtual dissection of the subtotal tongue.•FIPELS technique could provide a natural-shape subtotal tongue contour.•Functional and cosmetic outcomes are significantly improved by FIPELS technique. A no-flap design based on actual tongue anatomy has been reported to achieve precise reconstruction, but large carcinologic tongue defects remain extremely challenging to treat. The aim of this pilot study was to explore an anatomy-based flap design for precision subtotal tongue reconstruction. Thirty-five patients were randomly divided into two groups, a “five-points eight-line-segments” (FIPELS) technique flap design group (18 patients) and a conventional surgery group (17 patients), to undergo subtotal tongue reconstruction. All patients received an anterolateral thigh flap with nerve coaptation to the lingual or glossopharyngeal nerve. Swallowing function, speech intelligibility, and cosmetic results were assessed with a Likert scale, and epicritic and proprioceptive sensitivity and thermosensation of the neotongue were investigated. Outcomes were analyzed, and a p-value &lt; 0.05 was considered significant. The FIPELS flaps were significantly larger than conventionally designed flaps. All flaps healed uneventfully, except in two patients who presented with partial necrosis. Relative to patients in the conventional group, patients in the FIPELS group showed significantly improved swallowing function (p = 0.043) and cosmetic results (p = 0.017) but not speech intelligibility (p = 0.154). Patients in the two groups recovered comparably in terms of epicritic and proprioceptive sensitivity and thermosensation. The anatomy-based FIPELS technique is an innovative and effective solution for subtotal tongue reconstruction.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>30732945</pmid><doi>10.1016/j.oraloncology.2018.12.004</doi><tpages>7</tpages></addata></record>
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ispartof Oral oncology, 2019-02, Vol.89, p.1-7
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source ScienceDirect Journals
subjects Adult
Aged
Anterolateral thigh flap
Female
Five-points eight-line-segments
Humans
Male
Middle Aged
Nerve coaptation
Pilot Projects
Reconstructive Surgical Procedures - methods
Subtotal tongue reconstruction
Tongue - pathology
Tongue - surgery
Tongue cancer
Tongue Neoplasms - surgery
title A novel anatomy-based five-points eight-line-segments technique for precision subtotal tongue reconstruction: A pilot study
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