Radial Forearm versus Anterolateral Thigh Flap Reconstruction after Hemiglossectomy: Functional Assessment of Swallowing and Speech

Abstract

The authors retrospectively compared the results of postoperative speech and swallowing in patients who had undergone hemiglossectomy for carcinoma of the anterior tongue. Immediate reconstruction in 16 patients was with a free radial forearm flap and in another 16 with an anterolateral thigh flap. Clinical speech pathology evaluation included the Fletcher time-to-time maximum syllable repetition rate, multiple rhyme test, and overall quality and intelligibility of the patients' speech. Evaluation of swallowing included deglutition duration, bolus volume, and ingestion rate. The functional results with both flaps were adequate, and the two groups did not differ significantly between each other for either speech or swallowing.

Functional and Aesthetic Reconstruction of the Defects Following the Hemiglossectomy in Patients with Oropharyngeal Cancer

“…Concerning the question as to what is the best flap (radial forearm, anterolateral thigh, or deep inferior epigastric flap) for the reconstruction after hemiglossectomy, majority of recent papers suggest that the use of anterolateral thigh flap is the best option because the anterolateral thigh flap provide as good postoperative results as forearm flap whereas the former has less donor site morbidity than latter does [2][3][4][5]. We generally agree with them.…”

“…Regarding the volume of the flap for the defects of hemiglossectomy, there was some reports that discuss whether the reconstruction with flap is necessary or not [10,11], but most papers describe that reconstruction with free flap provide good functional results [1][2][3][4][5][6][7][8][9]. The flaps seen in these papers are comparatively large, and the size of reconstructed tongues is as large as that of original tongue.…”

“…Actually, many reports have described that the functional results are generally good after the reconstruction with flaps following hemiglossectomy [1][2][3][4][5][6][7][8][9]. However, it is rather difficult to perform the reconstruction that makes the best of remaining tissue and function.…”

Functional reconstruction of subtotal glossectomy defects with radial forearm free flap: case report and review of literature

“…For the former, fl aps previously described include the infrahyoid myofascial fl ap, the medial sural artery perforator fl ap, the RFFF and the ulnar forearm fl ap. 3,9,[13][14][15][16][17] For the latter, fl aps described include the rectus abdominis myocutaneous fl ap, the latissimus dorsi myocutaneous fl ap, the PMMF, and the trapezius island fl ap. [4][5][6][7] The ALTF has emerged in recent decades as a popular option for head and neck reconstruction because of its reliability, long pedicle, and good donor-site morbidity.…”

“…Options of free tissue transfer for tongue reconstruction include the rectus abdominis myocutaneous fl ap, latissimus dorsi myocutaneous fl ap, radial forearm fl ap (RFFF), and more recently, the ulnar forearm and the anterolateral thigh fl ap (ALTF), and the medial sural artery perforator fl ap. [6][7][8][9][10][11][12][13][14][15][16][17] In our hospital, we have successfully used the PMMF for reconstruction of total glossectomy defects.…”