Comparison of swallowing disorder in patients with tongue cancer undergoing reconstruction with either a radial forearm free flap or a submental island flap.

Abstract

In this study, the swallowing status of patients with tongue cancer undergone tongue reconstruction using radial forearm free flaps (RFFF) and submental flaps were compared. A total of 26 patients with tongue cancer undergone tongue resection were randomly treated by tongue reconstruction with either submental flap or RFFF approach. Swallowing status of the patients was investigated using fiberoptic endoscopic evaluation of swallowing (FEES) by measurement of pharyngeal residue and penetration scales. The pharyngeal residue scale in vallecula and pyriform sinus and the average of vallecula and pyriform sinus on days 10 and 30 post-operation as well as penetration scale at the same time showed no significant difference between two groups. However, the time to start oral feeding was significantly reduced in the submental group compared to the free flap group (P = 0.031). A positive Pearson correlation was found between the size of oral tongue and base of tongue resection and some of swallowing parameters. Since there was no significant difference between submental and free flap respected to swallowing disorder, the submental flap is prior to free flap due to lower cost and hospitalization and less complication after tongue reconstruction.