The New Tongue

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Abstract
Rehabilitation of major resections of the [human] tongue has always posed a serious problem. The feasibility and rationale of rehabilitating partial glossectomies by the use of the pectoralis major myocutaneous flap and the fabrication of a new tongue by the use of this flap are presented. The criteria for these techniques in benign and malignant tumors of the tongue are outlined. The segmental innervation of the pectoralis major muscle from a variety of 3-5 nerve branches permits the development of a skin-muscle flap that may be transposed with its nerve supply intact or totally denervated, depending upon the status of the hypoglossal nerves and tongue in the operative field. This presents the possibility of transposing a skin-muscle flap into a glossal wound with a completely intact nerve supply where the new flap is under constant instruction in its new physiologic environment. It also presents, possibility of neurotization of the denervated section of the muscle flap by axons from the intact segment of tongue. A 3rd possibility is the fabrication of a new tongue by the transfer of the hyopglossal nerves into the denervated segment of the peripheral aspect of the myocutaneous flap. This variety and combination of rehabilitative techniques introduces a new phase into the rehabilitation of the tongue.