3D Assessment of Tongue Volume after Free Flap Reconstruction: Validation of Technique

Abstract

Objectives: Use 3-dimensional volumetric analysis of postoperative computed tomography (CT) scans to characterize tongue volume and correlate measured values with swallowing function. Methods: Retrospective chart review of prospectively collected data. Fifteen patients treated with surgical resection and free flap reconstruction of the oral and base of tongue with or without postoperative irradiation between 2010 to 2012 were included in the study. Mimics program was used to obtain measurements of the oral tongue and tongue base volume, tongue base to oropharyngeal volume ratio, and tongue base to posterior pharyngeal wall distance by analyzing the postoperative 6-month and 1-year CT scans. Prospectively collected functional outcomes data, including aspiration/penetration score, perceptual evaluation of intelligibility, and G-tube dependence rates, were evaluated and correlated with dimensional analysis measures. Results: Adequate but not excessive tongue base volume correlated with reduced aspiration/penetration score and improved speech intelligibility. Oral tongue volume did not correlate with functional outcomes. Overall G-tube dependence rate was low in this cohort (13.3%). Conclusions: Three-dimensional analysis of tongue volume can be used to help predict postoperative swallowing outcomes.