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A Systematic Review and Meta-Analysis of Functional Tongue Reconstruction Using Dynamic Free Flap Designs.

O V Hovav1,2, D S Sparks1,2,3, G Velli2

  • 1Department of Plastic and Reconstructive Surgery, Gold Coast University Hospital, Southport, Australia.

Microsurgery
|December 16, 2025
PubMed
Summary
This summary is machine-generated.

Dynamic free flaps significantly improve speech and swallowing in patients after tongue cancer surgery. This reconstructive technique enhances functional recovery, offering better quality of life for patients undergoing glossectomy.

Keywords:
dynamicfunctionalglossectomyneurotizedreconstructiontongue

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Area of Science:

  • Head and Neck Surgery
  • Reconstructive Surgery
  • Oncology

Background:

  • Tongue cancer treatment often leads to significant deficits in speech, swallowing, and feeding, impacting patient quality of life.
  • Free tissue transfer is a primary method for reconstructing large tongue defects, aiming to restore function and protect the airway.
  • The effectiveness of dynamic free flaps with motor reinnervation for extensive glossectomy defects requires further evaluation.

Purpose of the Study:

  • To systematically review and evaluate speech and swallowing outcomes in patients who underwent dynamic free flap reconstruction after ablative tongue surgery.
  • To assess the role of dynamic free flap designs in functional tongue reconstruction.

Main Methods:

  • A systematic review of English-language studies from 1980 onward was conducted using MEDLINE, EMBASE, Cochrane Library, and Google Scholar.
  • Search terms included 'glossectomy,' 'functional reconstruction,' and related outcomes.
  • Primary outcomes were flap compromise, swallow competency, and speech intelligibility, with meta-analysis performed on pooled comparative data.

Main Results:

  • Thirteen studies involving 168 innervated flaps were analyzed, showing a low flap failure rate (1.2%).
  • Mean outcomes included 80.2% competent swallow and 91.7% satisfactory speech, with a mean follow-up of 21.8 months.
  • Dynamic free flaps demonstrated a significant improvement in swallow competency compared to static designs (OR = 4.09, p < 0.01).

Conclusions:

  • Dynamic free flap reconstruction appears to enhance functional recovery following tongue surgery.
  • Evidence suggests potential benefits for both swallowing and speech outcomes in the postoperative period.