Evaluation of Deglutition in Patients with Tongue Reconstruction Using a Radial Forearm Free Flap

To determine deglutition function in patients undergoing tongue reconstruction using a radial forearm free flap (RFFF).

A descriptive study. Place and Duration of the Study: Department of Plastic Surgery, Shifa International Hospital, Islamabad, Pakistan, from May 2025 to January 2026.

Patients with tongue malignancy who underwent reconstruction with RFFF during the study period were included. The deglutition function was assessed using a modified swallowing ability scale 6 months after surgery, which categorised patients into excellent, moderate, or poor function based on their ability to swallow. Data were analysed using SPSS version 24, and the deglutition function was stratified with demographics, clinical features, and comorbidities using the chi-square test. Statistical significance was set at p ≤0.05.

The mean age of the 30 patients was 49.5 ± 9.58 years. Postoperative deglutition outcomes showed excellent swallowing function in 100% of patients who underwent partial glossectomy and 76.19% of patients who underwent hemiglossectomy. However, patients with larger defects, such as those undergoing near-total glossectomies, did not achieve excellent postoperative swallowing function. These findings demonstrate a progressive decline in swallowing outcomes with increasing extent of glossectomy (p = 0.001).

Reconstruction with RFFF demonstrated excellent deglutition function in partial or hemiglossectomies. However, functional outcomes decline significantly with extensive resections, highlighting the need for further studies evaluating other reconstructive options, such as the anterolateral thigh flap, which provides greater bulk.

Radial forearm free flap, Tongue reconstruction, Deglutition, Swallowing function, Postoperative outcomes, Tongue cancer.