Posteriorly based Tongue flap reconstruction for Residive Ameloblastoma in Retromolar Region, the 3rd operation : A case report

Hamonangan HS; Syafri TM; Reksoprawiro S; Salim S

Volume : IX, Issue : VI, June - 2020

Posteriorly based Tongue flap reconstruction for Residive Ameloblastoma in Retromolar Region, the 3rd operation : A case report

Hamonangan Hs, Syafri Tm, Reksoprawiro S, Salim S

Abstract :

Background: The treatment of the oral cavity tumor is mostly surgical excision with the result of complex defects. Nowadays these defects are reconstructed with free flaps but they are not available in all institutes. Local flaps like tongue flap can be used in selected patients. We present the use of tongue flap in the reconstruction of a large defect of oral retromolar region. Methods : A 38–year–old man presented with a swelling on the left retromolar region. The lesion was asymptomatic and had been operated several times including segmental mandibulectomy. Intra–oral examination showed a sessile pink to red in color mass in retromolar area. Orthopantomogram (OPG) showed a soft tissue mass without bone destruction. The lesion was diagnosed as a squamous cell carcinoma, by cytologic examination but clinically suspected a peripheral ameloblastoma . Curative surgery was performed and reconstructed with tongue flap. Results: The postoperative course was uneventful. Surgery–related complications were not found. The final histopathology report was plexiform ameloblastoma. Discussion : Tongue which is adjacent to the site of excision can be used as it is highly vascular, elastic and central in location but within narrow limits. The principle of tongue flap is equitable redistribution of mucosa from relative abundance on the tongue to an adjoining excisional defect without significantly hampering the functions of the tongue. Conclusions : Posteriorly based dorsal tongue flap is a good option for certain selected cases. There is no significant morbidity at the donor site, primary closure of the donor area and it is a single staged procedure