Specialities » Head and Neck Tumour Surgery » Cancer of Hypopharynx » Total Glossectomy + Reconstruction with Gastro-omental Microvascular Flap

Total Glossectomy + Reconstruction with
Gastro-omental Microvascular Flap

Total Glossectomy + Reconstruction with Gastro-omental Microvascular Flap

Fig.1 Incision was made in floor of mouth. Rim resection of mandible was done on left side (green arrow).Using ‘pull-through’ technique, tongue is pulled into the neck. Total glossectomy, rim resection of mandible andepiglottectomy was done.

Fig.2 After total glossectomy, rim resection of mandible & bilateral neck dissection. White arrow – hyoid bone.

Fig.3 Resected specimen of total glossectomy & rim resection (white arrow).

Fig.4 Greater curvature of stomach and omentum were removed along with right gastroepiploic artery for reconstructing the tongue.

Fig.5 Larynx is pulled up and suspended from mandible (green arrows).This tucks the larynx under the neotongue to prevent aspiration. White interrupted line – hyoid bone.

Fig.6 Stomach wall is sutured to the mucosal edges in oral cavity and oropharynx (white arrow). Yellow arrow – omentum.

Fig.7 Omentum is tucked under the stomach wall and that gives a convex surface for the neotongue.

Fig.8 While swallowing, larynx moves up and gets tucked under the tongue base. This doesn’t happen after total glossectomy and results in aspiration. To prevent aspiration, anterior static laryngeal suspension is done.

Fig.9 Larynx is pulled up and suspended from mandible (green arrows).This tucks the larynx under the neotongue to prevent aspiration. White interrupted line – hyoid bone.

Fig.10 Post-op. Normal looking neotongue. Mucous secretion of the stomach wall solves the problem of dryness after radiotherapy.

Patient is drinking water 10 days after surgery without aspiration

The Heart Of Clinic

Dr. C. Rayappa MBBS, DLO, FRCS(Edin)

SENIOR CONSULTANT

+91 44 3315 1105

Dr. C. Rayappa graduated from Madras Medical College, Chennai, India in 1982. He completed his post graduation in Otolaryngology (ENT)

For Doctors

Need more information?

Reach us through mail or phone

The Heart Of Clinic

Dr. C. Rayappa MBBS, DLO, FRCS(Edin)

SENIOR CONSULTANT

+91 44 3315 1105

Dr. C. Rayappa graduated from Madras Medical College, Chennai, India in 1982. He completed his post graduation in Otolaryngology (ENT)

Mithun Das

03:35 18 Mar 23

Its a pleasure experience with Dr. Rayappa C. We came for my wife thyroid nodules operation and testing for cancer malignancy. Doctor taken care everything with my previous diagnosis report and suggest to surgery half of thyroid infected lob.After this operation we got biopsy report that indicate still cancer not affected.Thanks to doctor and wishes him all the very best.

Saima Hasin

07:07 13 Mar 23

A sincere and dedicated doctor. He treated my husband for Oral Cancer. He gave his best efforts to overcome the disease. With patience and sincerity he handled the post surgery stages. We are so thankful to him. Expressing our gratitude to Almighty Allah and of course to Dr.Rayappa for his recovery .

Reyad Alam

16:49 16 Feb 23

Just saying ‘Thank you’ will not justify what Dr. Rayappa sir has done for us.My mom was having difficulty in breathing for merely 2 years due to thyroid enlargement.So we consulted Dr.Rayappa and he asked us to do surgery as soon as possible. It was hard for us to take the decision since a lot of risks was involved but we went ahead with it.Post surgery - My mom feels so energetic and alive, which she never felt before. Can breathe better, can talk, and just recovered in 2 days. The surgery was a success and Dr. Rayappa and his team took great for us throughout. We can’t describe the joy and happiness we’re filled with to see my mother so healthy.We give our heartfelt gratitude to Dr.Rayappa sir and his team.Dr. Rayappa is a great Otolaryngologist and we highly recommend him.

Poojha Shri

15:49 06 Feb 23

This is Vanamadevi patient of Dr.Rayappa. Dr sir is a God in the form of human. Highly blessed to be treated by him.Gave us hope in a hopeless situation. Very good service by the whole team. Thank you.

Rajiya Sultana

08:47 06 Jan 23

I am very much satisfied in your treatment. Dr.Rayappa sir is a very kind hearted man and a great doctors ever seen in my life.May Allah bless him and his family.

Total Glossectomy + Reconstruction with
Gastro-omental Microvascular Flap