Functional outcome after partial glossectomy with reconstruction using radial forearm free flap

Abstract

The purpose of this study was to investigate the relationship between the radial forearm free flap (RFFF) volume changes and speech and swallowing outcomes. The study included 18 subjects with squamous cell carcinoma of the oral tongue. Average percentage changes in flap volume between 3 and 12 months was 19.2%. Postoperative free flap volume changes were significantly and negatively correlated with the word and sentence intelligibility (Y=-0.338X+43.641, r(2)=0.383, p=0.006 and Y=-0.246X+34.322, r(2)=0.321, p=0.014, respectively). A significant positive correlation was also found between word and sentence intelligibility and floor of mouth resected, postoperative irradiation. Postoperative flap volume changes between 3 and 12 months were correlated with reduced posterior bolus movement by tongue (p=0.002), reduced tongue base to posterior pharyngeal wall contact (p=0.002), reduced laryngeal elevation (p=0.005), increased aspiration (p=0.005), delayed oral (p=0.010) and pharyngeal transit time (p=0.011). Floor of mouth resected, tongue base resected, and postoperative irradiation also influenced the swallowing outcomes. This study shows that postoperative flap volume changes are significantly related to speech and swallowing outcomes in patients undergoing partial glossectomy reconstructed with RFFF.