The Modified "ICTM" technique for total tongue reconstruction using profund artery perforator flap.

[OBJECTIVE] Total tongue reconstruction is one of the most complex procedures in head and neck surgery. Achieving favorable functional outcomes requires a free flap with sufficient volume and precise design. This study aimed to evaluate the clinical application of the modified "Individualized and Convenient Tongue Model" (ICTM) technique for total tongue reconstruction using profunda artery perforator flaps (PAPF).

[METHODS] This retrospective study included 58 participants who underwent total tongue reconstruction with PAPFs between January 2018 and December 2023. Of these, 29 underwent reconstruction using the modified ICTM technique, while 29 received the conventional flap design. Functional and aesthetic outcomes were assessed using standardized evaluation scales. Statistical analysis was performed, with a p-value <0.05 considered significant.

[RESULTS] PAPFs designed with the modified ICTM technique successfully reconstructed neotongues with improved volume, contour, and sustained protuberance compared to the conventional group. Participants in the modified ICTM group demonstrated significantly greater improvements in speech intelligibility (p = 0.023), swallowing function (p = 0.008), and cosmetic appearance (p = 0.001).

[CONCLUSIONS] For total tongue reconstruction, PAPFs designed with the modified ICTM technique offer superior closure of oropharyngeal wounds and enhanced functional and aesthetic outcomes compared to conventional flap designs.