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Long‐term functional outcomes after total tongue reconstruction: Consideration of flap types, volume, and functional results
Author(s) -
Jeong Woon Hyeok,
Lee Won Jai,
Roh Tai Suk,
Lew Dae Hyun,
Yun In Sik
Publication year - 2017
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.22440
Subject(s) - medicine , swallowing , surgery , microsurgery , free flap , tongue , wound dehiscence , dysphagia , pathology
Objective The purpose of this study is to evaluate the long‐term results of flap volume change, swallowing capacity, speech intelligibility, and differences between vertical rectus musculocutaneous (VRAM) and anterolateral musculocutaneous (ALT) free flaps in total tongue reconstruction. Patients and methods We retrospectively analyzed the medical records of 31 patients who underwent total tongue reconstruction with VRAM (24 cases) and ALT flap (7 cases). The mean age of patients was 52.09 ± 2.25 years. The tumor types were as follows: squamous cell carcinoma (28 cases), adenoid cystic carcinoma (2 cases), and metastatic cancer (1 case). The flap volume was determined based on clinical and imaging examinations. Swallowing and speech function were analyzed using seven‐point rating scales. Results All flaps survived eventually after surgery; however, 1 patient underwent VRAM flap experienced partial flap necrosis, wound dehiscence in 4 patients underwent VRAM flap, and infection in 3 patients (VRAM; 2 patients, ALT; 1 patient). The mean follow‐up period was 3.97 ± 0.54 years. The volume of the flaps remained relatively constant over time. The swallowing capacity positively correlated with the flap volume ( P < 0.0001); however, the speech intelligibility did not correlate with the flap volume in analysis of total cohort. There were no statistical differences in functional outcomes between the two types of reconstructed flaps ( P > 0.05). Conclusion The preservation of flap volume was important to achieve superior swallowing capacity; however, it was insufficient to promote the speech outcome. The functional outcomes did not differ depending on the type of flap. © 2015 Wiley Periodicals, Inc. Microsurgery 37:190–196, 2017.