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Tumor and Flap Reconstruction Volumes and Functional Outcomes after Glossectomy
Shannon S Wu1, Anushka S Jetly2, Heather M Starmer1
1Division of Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California.
JAMA Otolaryngology-- Head & Neck Surgery
|March 19, 2026
Summary
Tumor and resection volumes significantly impact speech and swallowing after oral tongue cancer surgery. Restoring tongue volume improves oral intake, guiding better surgical planning and patient outcomes.
Area of Science:
- Oncology
- Head and Neck Surgery
- Speech and Swallowing Rehabilitation
Background:
- Oral tongue cancer is the most common oral cancer, with increasing incidence.
- Tongue resection can lead to significant morbidity, affecting speech, swallowing, and quality of life.
Purpose of the Study:
- To assess the association between tumor volume, extent of tongue resection, and functional outcomes.
- To identify risk factors for poor functional outcomes after oral tongue cancer surgery.
Main Methods:
- Retrospective cohort study of 357 patients with oral tongue squamous cell carcinoma.
- Volumetric analysis of tumor, tongue, and flap dimensions.
- Multivariable and regression analyses to correlate volumes with functional outcomes (e.g., FOIS, speech intelligibility).
Main Results:
- Total or subtotal glossectomy (TG) cohort showed worse functional outcomes compared to partial or hemiglossectomy (PG).
- Greater resection volume, preoperative tumor fraction (>31%), and resection volume fraction (>67%) were associated with gastrostomy tube dependence (FOIS ≤3).
- Specific volumetric thresholds were linked to impaired speech intelligibility and swallowing.
Conclusions:
- Volumetric analysis reveals significant associations between tumor/resection volumes and speech/swallow outcomes.
- Quantitative assessment of tongue resection and restoration volumes can improve preoperative counseling and functional outcomes.
