Analysis of relationship between postoperative articulation and shape of the reconstructed tongue in the patients after glossectomy

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Twenty patients with advanced carcinoma of the floor of the mouth and the tongue were treated with hemiglossectomy (12 patients), subtotal (7 patients), or total glossectomy (1 patient) and immediate reconstruction with various kinds of flaps : rectus abdominis mus culocutaneous free flap, radial forearm free flap, or pectoralis major musculocutaneous flap. The reconstructed tongues were divided into three groups in shape (protuberant, flat, and depressed one) by intraoral inspection and intelligibility of speech was evaluated by a speechtherapist over 6 months after surgery. The results indicated intelligibility was more impaired in the patients underwent more extensive glossectomy. In the protuberant group the patients with hemiglossectomy (7 patients) had the best speech intelligibility, in the flat group (4 patients) the second, and in the depressed group (1 patient) the worst. On the other hand, we could not compare these groups in subtotal and total glossectomied patients because of almost of the reconstructed tongue to be protuberant. In the protuberant group of the patients with hemiglossectomy mobility of the remaining tongue was not interfered by the transferred laps. We suppose that may be one of the reasons for good intelligibility of postoperative speech.
特定非営利活動法人日本頭頸部外科学会の論文