OP073: Correlation of differences in elevation and protrusion to speech and swallowing function in hemiglossectomy defects reconstructed with a rectangle tongue template

Abstract

Purpose There are few studies that have measured reconstructive metrics after tongue reconstruction and examined their relationship to speaking and swallowing. The purpose of this study is to correlate the reconstructive metrics of tongue elevation and protrusion with speech and swallowing function in patients with hemiglossectomy defects reconstructed with a rectangle tongue template. Material and methods 32 patients (m:f; 18:13 mean age) underwent resection and free-tissue reconstruction of hemiglossectomy defects using a rectangle tongue template between 2000 and 2009. The Head and Neck Speech and Swallowing Assessment (administered functional outcomes instrument) and measurements of elevation and protrusion were recorded greater than 12 months postoperatively. Results The mean tongue tip elevation was 2.4 cm (range 0.5–5.0 cm) and the mean protrusion was 1.4 cm (0–3.6 cm). Elevation of the tongue >1.5 cm correlated with improved scores in nutritional mode (5.8 vs 4.8; p = 0.011), range of liquids (5.9 vs 5.0; p = 0.009), range of solids (5.2 vs 3.6; p = 0.01), eating in public (4.5 vs 3.6; p = 0.039), and understandability (4.6 vs 3.8; p = 0.012). Protrusion of the tongue greater ⩾0.8 cm correlated with improved scores in nutritional mode (5.8 vs 5.0; p = 0.01), range of solids (5.4 vs 3.6; p = 0.0001), eating in public (4.7 vs 3.4; p = 0.0001), understandability (4.6 vs 4.0; p = 0.02) and speaking in public (5.0 vs 4.4; p = 0.004). Conclusions The rectangle tongue template for hemiglossectomy reconstruction provides effective restoration of speech and swallowing function. Tongue elevation and protrusion scores greater than 1.5 and 0.8 cm, respectively, are ideal surgical goals for functional speech and swallowing results.