Speech and swallowing following tongue cancer surgery and free flap reconstruction – A systematic review

A systematic review of quality of life in head and neck cancer treated with surgery with or without adjuvant treatment

“…Extensive surgical resection and/or the need for flap reconstruction [22,[25][26][27]30,35,39,40] is associated with poor QoL outcomes, especially for speech and swallowing; this may be in part because adynamic free flaps impair symmetry and mobility of residual normal anatomy. Literature evaluating objective speech and swallowing functions also supports an association of extensive surgical resection and the need for flap reconstruction with poor speech and swallowing function [57][58][59]. Extensive mandibular resection [22,26,27] has shown conflicting effects on QoL.…”

“…In LX cancers, only one study evaluated QoL, comparing surgical treatment alone to surgery with PORT; this showed a trend toward better QoL with combined modality treatment [23]. Radiation-induced salivary dysfunction [60] and dysphagia [58,59] are well-studied issues in HNC management. Our review confirms the association of adjuvant radiation with dryness of mouth, sticky saliva and problems with mouth opening.…”

Tongue Transplantation

“…Although closely coordinated and structurally connected, for reconstructive purposes, the oral tongue and base of tongue are functionally distinct [5]. The oral tongue's function relies heavily upon its flexibility and mobility.…”

“…It plays a vital role in initiating pharyngeal swallowing by propelling the food bolus into the posterior pharyngeal wall. Its bulk promotes passage of the food bolus over and around the larynx for airway protection [5,7,8]. The tongue's multi-purpose nature and almost whimsical mobility create difficult challenges for the head and neck reconstructive surgeon.…”

Cancers of the Tongue and Floor of Mouth: Five-Year File Audit Within the Acute Phase

“…For tumors of small size, surgical removal and primary wound closure is the surgical goal; however, reconstruction using donor tissue is often required following removal of larger tumors (Lam & Samman, 2013).…”