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Speech function following maxillectomy reconstructed by rectus abdominis myocutaneous flap
1First Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University, Tokyo, Japan.
Summary
Reconstructing maxillary defects with rectus abdominis myocutaneous flaps (RAMCF) shows similar speech intelligibility to non-reconstructed patients. Optimal speech function requires restoring maxillary contours for better linguopalatal contact.
Area of Science:
- Oral and Maxillofacial Surgery
- Speech Pathology
- Reconstructive Surgery
Background:
- Maxillary defects post-surgery pose challenges for speech function.
- Microvascularized free flaps are increasingly used for reconstruction, but speech outcomes are under-reported.
Purpose of the Study:
- To compare speech intelligibility in patients reconstructed with rectus abdominis myocutaneous flaps (RAMCF) versus non-reconstructed patients.
- To identify factors influencing speech function after maxillary reconstruction.
Main Methods:
- Speech intelligibility was assessed using a Japanese language test.
- Four patients reconstructed with RAMCF were compared to four non-reconstructed patients (split-skin grafts and prostheses).
Main Results:
- Mean speech intelligibility scores were comparable: 70.4% (non-reconstructed) and 71.0% (RAMCF group).
- Speech disorders stemmed from oronasal separation issues (non-reconstructed) and linguopalatal contact problems (RAMCF group), particularly for specific consonant sounds.
Conclusions:
- Restoring dentoalveolar and palatal contours is crucial for improving speech function in reconstructed maxillae.
- This principle applies to reconstructions using various microvascularized flaps with similar palatal surfaces.