[Oral Floor Reconstruction with Digastric Muscle Bipedicle Flap for Advanced Tongue Cancer in Very Elderly Patients-Report of Two Cases].

In recent years, the opportunity to treat oral cancer in elderly patients has been increasing because of the increased lifespan of individuals. Standard treatment for advanced tongue cancer involves reconstruction of the tongue with a free vascularized flap. However, this may not always be suitable for elderly patients because the procedure is lengthy and invasive and also because of their medical history. We report 2 cases of elderly patients undergone oral floor reconstruction with digastric muscle bipedicle flap for advanced tongue cancer. In case 1, an 86-year-old woman underwent pull-through ablation surgery with partial glossectomy and modified radical neck dissection for the treatment of left-sided tongue cancer(well-differentiated squamous cell carcinoma, cT3N2bM0, Stage ⅣA). In case 2, a 93-year-old man underwent pull-through ablation surgery with hemiglossectomy and suprahyoid neck dissection for treatment of right-sided tongue cancer(verrucous carcinoma, cT3N0M0, Stage Ⅲ). In both patients, the flap was sutured to the mandibular border, mandibular periosteum and surrounding tissue, and the intraoral mucosa and neck were isolated. Compared to the reconstruction of the tongue with a free vascularized flap, the procedure used in these 2 cases was shorter and caused less bleeding. Moreover, the patients exhibited no postoperative dysfunction, and clinical outcome remained favorable. We believe that oral floor reconstruction with digastric muscle bipedicle flap at the bottom of the mouth was effective in reducing surgical stress and restoring oral function in very elderly patients.