Repair of anterior floor of mouth defects by a central or paramedian island tongue flap.

One method for restoring the anterior floor of mouth defects resulting from T(1) and especially T(2) cancer excision involves the creation of a myomucosal island flap from the dorsal median portion of the tongue and transferring it as a transit flap to the floor of the mouth. We are not the first to advocate this method. In this paper we present a previously unreported, slightly modified technique utilizing this tongue flap. The modification consists of a 90 degrees twisting of the flap to achieve a more appropriate adaptation to the defect. In the case of spreading carcinoma from the floor of the mouth to the central portion of the tongue, a similar paramedian one-sided tongue flap was created instead of a central island tongue flap. Our present experience consists of a small series of 12 patients. The procedures were successful in all patients. No remarkable disturbances of speech or deglutition were observed in any of the patients. There were two complications: one haematoma and one partial necrosis of the tip of the tongue. In our opinion, the reconstruction of the anterior floor of mouth defects using a central island tongue flap has not gained the popularity it deserves.