When doctors remove tongue cancer, they need to rebuild the tongue so patients can eat and talk normally. Researchers tested a new surgical technique using healthy skin from the calf to rebuild the tongue in three cancer patients. The special part of this technique is leaving the tip of the original tongue unattached, which helps patients move their tongue better after surgery. All three patients recovered well, could eat regular food within two weeks, and had clear speech after therapy. The scars on their calves were small and barely noticeable. This new approach appears to give patients better function while causing less damage to the donor area.

The Quick Take

  • What they studied: A new surgical technique for rebuilding the tongue and mouth floor after cancer removal, using skin from the calf and keeping the original tongue tip mobile
  • Who participated: Three patients (ages 28, 50, and 36) who had lateral tongue cancer requiring partial tongue removal
  • Key finding: All three patients recovered successfully with good eating and speech function, returned to normal diet within 2-3 weeks, and had minimal scarring on the calf where the skin graft came from
  • What it means for you: If you or a loved one needs tongue cancer surgery, this technique may offer better speech and eating outcomes compared to traditional methods, though more research with larger patient groups is needed to confirm these benefits

The Research Details

This is a case report, which means doctors documented their experience with three individual patients who had the same type of surgery. Each patient had a tumor on the side of their tongue that required removal of part of the tongue and surrounding tissue. The surgical team used a specialized technique called a medial sural artery perforator flap, which involves taking healthy skin and tissue from the inner calf and carefully moving it to the mouth to fill the gap left by cancer removal. The key innovation was intentionally leaving the patient’s original tongue tip unattached to the new tissue, allowing it to move freely and improve function. The surgeons connected tiny blood vessels from the new tissue to blood vessels in the neck to keep the transplanted tissue alive.

This research approach is important because it shows real-world results in actual patients rather than laboratory tests. Case reports are often the first step in introducing new surgical techniques. By carefully documenting what happened with these three patients—including how well they recovered, when they could eat, and how their speech sounded—the surgeons provide evidence that this technique is worth studying further in larger groups of patients.

This is a small study with only three patients, so the results should be viewed as promising but not definitive. The patients were followed for different lengths of time (3-6 months after treatment), which is relatively short-term. There was no comparison group of patients who had traditional surgery, so we can’t directly compare outcomes. However, all three patients had successful outcomes with no serious complications, which is encouraging. The detailed documentation of each case provides valuable information for other surgeons considering this technique.

What the Results Show

All three patients had successful surgery with no major complications. The transplanted tissue from the calf survived completely in all cases, meaning the blood vessels connected properly and the tissue stayed healthy. Patients were able to start eating regular food within 12-18 days after surgery, which is relatively quick recovery. All three patients developed understandable speech after working with a speech therapist, though the quality varied slightly among patients. The calf areas where tissue was removed healed with small, thin scars that were barely noticeable, and none of the patients experienced weakness or problems with their legs. When examined 3-6 months after treatment, all patients could eat any type of food without difficulty, indicating good mouth function had returned.

The patients tolerated additional cancer treatment (radiation therapy) well after surgery. The preserved tongue tip appeared to contribute to better overall tongue mobility and function compared to what might be expected with traditional reconstruction methods. The donor sites (calves) healed without infection or other complications, and patients reported no long-term problems with walking or leg function. The mouth tissue remained flexible and supple, which is important for eating and speaking.

Traditional tongue reconstruction often uses larger tissue grafts that can be bulky and limit tongue movement. This new technique appears to offer better balance between having enough tissue to fill the defect while maintaining flexibility. By preserving the original tongue tip, this approach may improve outcomes compared to methods that completely replace the tongue tissue. However, direct comparison studies would be needed to confirm this advantage.

This study included only three patients, which is a very small number. Different patients may respond differently to surgery, so results from three people cannot be reliably applied to all patients. The follow-up time was relatively short (3-6 months), so we don’t know how patients function years later. There was no control group of patients who had traditional surgery, making it impossible to directly compare this new technique to standard approaches. The patients were different ages and may have had different types of cancer severity, which could affect results. Long-term speech quality and eating function weren’t formally measured with standardized tests.

The Bottom Line

This surgical technique appears promising for patients with medium-sized tongue cancers, but it should only be performed by experienced microsurgeons at specialized cancer centers. The technique may be particularly beneficial for patients where preserving tongue mobility is important. More research with larger patient groups is needed before making this a standard treatment option. Patients should discuss this option with their cancer surgery team to determine if they are good candidates. Confidence level: Moderate—based on three successful cases, but larger studies are needed.

This research is most relevant to people with lateral (side) tongue cancer who need partial tongue removal. It may also interest head and neck surgeons, cancer patients considering reconstruction options, and people concerned about quality of life after cancer surgery. This technique is not appropriate for very large defects or patients who cannot undergo microsurgery. People with other types of mouth cancer should consult their doctors about whether this approach applies to their situation.

Patients in this study could eat soft foods within 2-3 weeks and had understandable speech after rehabilitation (typically 4-6 weeks of therapy). Full recovery with normal eating and speech typically takes 2-3 months. Long-term adaptation and improvement may continue for 6-12 months after surgery.

Want to Apply This Research?

  • Track daily food consistency tolerance (soft, regular, hard foods) and speech clarity on a 1-10 scale to monitor functional recovery progress over weeks and months post-surgery
  • Set reminders for speech therapy exercises and swallowing practice sessions, log completed exercises, and track pain levels during eating to support rehabilitation goals
  • Create a recovery timeline with milestones (first soft foods, first regular foods, return to normal diet) and monitor calf wound healing with weekly photo documentation and notes on any swelling or discomfort

This research describes a specialized surgical technique for tongue cancer reconstruction performed only by experienced microsurgeons. This information is educational and should not replace consultation with your medical team. Surgical outcomes vary based on individual factors, cancer stage, and surgeon experience. If you have tongue cancer or are considering reconstruction surgery, discuss all available options with your oncologist and head and neck surgeon. This case report involves only three patients; larger studies are needed to establish this as standard treatment. Always seek care from qualified cancer specialists at accredited medical centers.