Primary Closure Versus Radial Forearm Flap Reconstruction After Hemiglossectomy: Functional Assessment of Swallowing and Speech

A videofluoroscopic study comparing severe swallowing disorders in patients treated surgically or with radiation for oropharyngeal cancer

“…Free flap reconstruction techniques can improve the functional repercussions when more than 50% of the root of the tongue is resected. 20,25 We found a similar incidence of aspiration in the two groups of our population, around 65% after surgical or non-surgical treatment, which is comparable to the incidence reported in previous studies. 5,10 Precise analysis of the type of aspiration provided significantly different results.…”

Swallowing Function in Patients Who Underwent Hemiglossectomy: Comparison of Primary Closure and Free Radial Forearm Flap Reconstruction With Videofluoroscopy

“…This excellent mobility of the remaining tongue allows the patient to have good speech. 6,[12][13][14] However, the tongue displacement and volume loss converts the remaining tongue into an ineffective organ for swallowing. The tongue cannot reach the palate and pharynx for food transport.…”

“…Therefore, flap reconstruction usually is required if more than 50% of the tongue is resected. 2,4,5 In a previous work, 6 we assessed tongue function in hemiglossectomized patients and found that swallowing, including the bolus volume and ingestion rate, was better in patients with a free radial forearm flap reconstruction. We suggested that the flap adds bulk, thus improving pharyngeal clearance by maintaining the tongue-to-palate contact necessary in the swallowing process.…”

Function of the sensate free forearm flap after partial glossectomy

“…Schmelzeisen et al (1996) demonstrated that lack of neurosensitive feedback may be responsible for poor speech results despite good floor of mouth/ tongue mobility following reconstruction. The main objective of the partial tongue reconstruction is to allow free mobility for the residual tongue, in order to enable substitution of as many functions of the removed stump as possible (Hsiao et al, 2002(Hsiao et al, , 2003a. Currently, a free forearm fasciocutaneous flap is considered the first choice for tongue reconstruction following hemiglossectomy (Urken et al, 1994).…”