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Functional outcome after total and subtotal glossectomy with free flap reconstruction
Chie Yanai1, Takesi Kikutani, Masatosi Adachi
1Clinical Centre for Oral and Maxillofacial Oncology, Nippon Dental University Hospital, Tokyo, Japan. cyanai@db3.so-net.ne.jp
Background:
The aim of this study was to evaluate postoperative oral functions of patients who had undergone total or subtotal (75%) glossectomy with preservation of the larynx for oral squamous cell carcinomas.
Methods:
Speech intelligibility and swallowing capacity of 17 patients who had been treated between 1992 and 2002 were scored and classified using standard protocols 6 to 36 months postoperatively. The outcomes were finally rated as good, acceptable, or poor.
Results:
The 4-year disease-specific survival rate was 64%. Speech intelligibility and swallowing capacity were satisfactory (acceptable or good) in 82.3%. Only 3 patients were still dependent on tube feeding. Good speech perceptibility did not always go together with normal diet tolerance, however.
Conclusions:
Our satisfactory results are attributable to the use of large, voluminous soft tissue flaps for reconstruction, and to the instigation of postoperative swallowing and speech therapy on a routine basis and at an early juncture.