Speech and swallowing outcomes with infrahyoid myo cutaneous flap after compartmental tongue resection: a prospective...

Compartmental glossectomy has emerged as an oncologically sound approach for tongue carcinoma; however, it is often associated with the need for reconstruction due to the resulting floor-of-mouth defect. This prospective study focuses on reconstruction, including its surgical and functional outcomes for speech and swallowing, using the Infra Hyoid Myocutaneous Flap (IHMCF) after compartmental resection for tongue squamous cell carcinoma.

A total of 36 patients with histologically proven squamous cell carcinoma of the lateralized tongue were enrolled during the study period from January 2021 to November 2022. Patients undergoing conventional compartmental resections were included in the study. The male-to-female ratio was 5:1, and the median age of the cohort was 43.5 years. The T-stage distribution for the study population was: T2-18; T3-16; and T4a - 2. Outcomes were assessed objectively using cine fluoroscopy for swallowing and subjectively for speech. The flap outcomes were evaluated for survival, partial necrosis, and complete necrosis. Partial necrosis was termed for superficial epithelial necrosis with preserved underlying muscle.

Complete flap survival was seen in 83.3% cases (N = 30/36). Partial or complete flap loss was noted in 11.1% (n = 4/36) and 5.6% (n = 2/36), respectively. The cumulative flap survival in this study group was 94.4%. All patients could be started on oral feeds at an average of 3 weeks postoperatively (range 2 to 4.5 weeks). Cine fluoroscopy was used to evaluate swallowing, yielding acceptable results. Speech was comprehensible for all the patients and correlated with the extent of resection.

Infrahyoid Myocutaneous flap is a viable option for tongue reconstruction after compartmental glossectomy with acceptable speech and swallowing outcomes.