Abstract
Background Reconstruction in tongue cancer to restore the shape and function of the tongue without
airway obstruction in the narrow oral cavity is challenging for reconstructive surgeons.
Herein, the authors retrospectively analyzed flaps to reveal the factors that affect
the functional outcome of tongue reconstruction.
Methods Herein, we retrospectively reviewed 30 patients (men, 16; women, 14; mean age, 50.3
years) who underwent the hemi-tongue reconstruction followed by speech therapy between
2009 and 2017. Data about postoperative chemotherapy and radiotherapy were collected.
The dimensions (width and length) of the flaps were measured. Speech outcomes were
assessed under the conditions of varying distances of the tongue tip from lower incisors
when it was protruded, retracted, and elevated. Lateralization was evaluated based
on the count of teeth reached by the tip of the tongue from the midline.
Results Preoperative chemotherapy and radiotherapy significantly influenced tongue retraction,
tongue articulation, and intelligibility (p = 0.006, 0.002, 0.048, respectively). Postoperative chemotherapy did not statistically
significantly influence any outcome measure. Contralateralization of the tongue was
significantly decreased in the postoperative radiotherapy group (p = 0.029). The length of the flap showed highly negative correlation with articulation
and intelligibility (p = 0.009, p< 0.001, respectively). The width of the flap was not correlated with the outcomes.
Conclusion We proved that unlike chemotherapy, postoperative radiotherapy influences the functional
outcome of tongue reconstruction. The dimensions, particularly the length of the flap,
were also important for restoring the reconstructed tongue function.
Keywords
speech - tongue - reconstructive surgical procedures
