Evaluation of Tongue Functions After Free Flap Reconstruction
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ORIGINAL ARTICLE
Evaluation of Tongue Functions After Free Flap Reconstruction Vanita Sarin1
•
Arpita Chatterjee2 • Vikas Kakkar3 • Ateev Juneja4
Received: 14 August 2020 / Accepted: 23 September 2020 Ó Association of Otolaryngologists of India 2020
Abstract Squamous cell carcinoma of the tongue is the most common malignancy of the oral cavity, the lateral border being the commonest site. The treatment strategies mandate surgery followed by appropriate reconstruction as the first line of management. There are many suitable methods of reconstruction of tongue defects after surgery, but the principle of an ideal reconstruction method should provide not only satisfactory structural cosmesis, but also good restoration of function. We present our experience with the skin lined free flaps reconstruction for defects of the tongue and floor of mouth, and present analyses of the functional outcomes of reconstruction. This prospective longitudinal study included 93 patients and was conducted in a tertiary care center in Punjab. All patients underwent free flap reconstruction after tumor removal. The functional outcome of the tongue following reconstruction was evaluated 9 months after the & Vanita Sarin [email protected] Arpita Chatterjee [email protected] Vikas Kakkar [email protected] Ateev Juneja [email protected] 1
Department of Otorhinolaryngology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
2
Department of Audiology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
3
Department of Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
4
Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, India
completion of treatment. Functions were assessed and matched with sexes and age-matched normal individuals. The data obtained were analyzed by the student ‘t’ test and the p values \ 0.05 were considered statistically significant. The duration of swallowing in patients with FRF flap and ALT flap when compared to the normative was significant (\ 0.05). There were changes in configuration and volume of the oral cavity after surgery which generates resonant and articulatory alterations, thus the intelligibility of the patient’s speech is lowered. There is also a restriction in the tongue movements and reduction in the sensations of the reconstructed part of the tongue. Both the free ALT flap and the FRF flap can provide acceptable functional restoration of the tongue after radical tumor resection. Keywords Squamous cell carcinoma Free flap Speech therapy Reconstruction ALT
Introduction Squamous cell carcinoma (SCC) of the oral tongue is an aggressive disease and constitutes 22%–39% of oral cavity cancers [1]. It is the most common malignancy of the oral cavity. The commonest site involved is the lateral border followed by the tongue, base and, the tip of the tongue. The current treatment strategies mandate surgery with appropriate reconstruction which depends upon the residual tongue
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