[Comparison of free anterolateral thigh perforator flaps versus free forearm flap for reconstruction in elderly patients undergoing glossectomy]

Objective: To evaluate the quality of life (QOL) in elderly patients with tongue cancer who underwent immediate free flap reconstruction surgery. In addition, the efficacy of the anterolateral thigh perforator free flap (ALTFF) and the radial free forearm flap (RFFF) for reconstruction was compared in patients with glossectomy. Methods: Ninty-eight patients undergoing complete or partial glossectomy and reconstruction with free flaps were grouped according to flap type. Oral functions were assessed using The University of Washington Quality of Life (UW-QOL), and the 14-item Oral Health Impact Profile questionnaires (OHIP-14) at 6 and 12 months after reconstructive surgery. Results: Eighty-six of 98 questionnaires (88%) were returned. There was significant difference between the 2 groups in the style of resection (P<0.05). For all oral function domains, the score improved progressively after the operation (6 and 12 months after the procedure). The UW-QOL questionnaire showed a significant difference between the 6 months postoperatively (ALTFF: 290.0 ± 7.8, RFFF: 236.6 ± 24.2) and 12 months postoperatively (ALTFF: 302.0±21.1, RFFF: 331.1±20.4) (P<0.05). The OHIP-14 questionnaire showed a total score of ALTFF (422.0± 15.2) which was significantly less than RFFF (434.0±38.7) at 6 months postoperatively (P<0.05). There were no meaningful differences between the 2 flap types for all oral function domains at 12 months. Conclusions: Using the RFFF or ALTFF for reconstruction of tongue defects after cancer resection influences oral function. There was no significant difference in quality of life between the two flaps at 12 months postoperatively.