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Functional Outcomes after Subtotal/Total Glossectomy with Microsurgical Reconstruction: A Multicenter Prospective

Jun Araki1, Keita Mori2, Yoshichika Yasunaga3,4

  • 1Division of Plastic and Reconstructive Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan. ja980079@yahoo.co.jp.

Annals of Surgical Oncology
|July 12, 2025
PubMed
Summary

Tongue reconstruction after cancer surgery can lead to feeding tube dependence, affecting oral intake and speech. Identifying risk factors like defect type and treatment helps optimize patient outcomes.

Keywords:
Feeding tube dependenceMicrosurgical reconstructionOral intake levelSpeech functionSubtotal/total tongue reconstruction

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Area of Science:

  • Oncology
  • Head and Neck Surgery
  • Reconstructive Surgery

Background:

  • Assessing functional outcomes after tongue reconstruction is crucial for patient quality of life.
  • Understanding risk factors for feeding tube dependence, oral intake, and speech is essential for surgical planning.

Purpose of the Study:

  • To identify risk factors for feeding tube dependence, oral intake level, and speech function after tongue reconstruction.
  • To provide evidence-based data for optimizing functional outcomes in patients undergoing glossectomy.

Main Methods:

  • Prospective observational multicenter study involving 21 Japanese institutions.
  • Included patients with oral tongue squamous cell carcinoma undergoing subtotal/total glossectomy and microsurgical reconstruction.
  • Functional evaluations (feeding tube dependence, oral intake, speech) were performed 1 year postoperatively.

Main Results:

  • 121 patients completed the 1-year follow-up; 12.4% experienced feeding tube dependence.
  • Feeding tube dependence was linked to tongue defect type, laryngeal suspension, and postoperative chemotherapy.
  • Oral intake was affected by age, laryngeal suspension, and postoperative chemoradiation; speech function by numerous factors including age, comorbidities, tumor stage, and treatment modalities.

Conclusions:

  • Identified key risk factors for predicting functional outcomes after tongue reconstruction.
  • Results aid surgeons and patients in making informed decisions to optimize functional results.
  • Provides valuable data for personalized treatment strategies in head and neck cancer reconstruction.