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Correlation of neotongue volume changes with functional outcomes after long-term follow-up of total glossectomy.

Authors
 In Sik Yun  ;  Dong Won Lee  ;  Won Jai Lee  ;  Dae Hyun Lew  ;  Eun Chang Choi  ;  Dong Kyun Rah 
Citation
 JOURNAL OF CRANIOFACIAL SURGERY, Vol.21(1) : 111-116, 2010 
Journal Title
JOURNAL OF CRANIOFACIAL SURGERY
ISSN
 1049-2275 
Issue Date
2010
MeSH
Deglutition ; Female ; Glossectomy/methods* ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Speech Intelligibility ; Surgical Flaps*/blood supply ; Surgical Flaps*/innervation ; Survival Rate ; Tongue Neoplasms/physiopathology ; Tongue Neoplasms/surgery* ; Treatment Outcome
Keywords
Total glossectomy ; total tongue reconstruction ; rectus abdominis musculocutaneous free flap ; functional outcome ; volume reduction
Abstract
As the survival rate of tongue cancer has increased, longer-term results of tongue reconstruction are also being considered. The aim of this study was to report the long-term outcomes of total glossectomy.Of 14 patients who underwent total glossectomy, 11 were reconstructed with the rectus abdominis musculocutaneous free flap and 3 with the anterolateral thigh free flap. We reviewed survival rate, swallowing capacity, speech intelligibility, and volume reduction in flaps. Swallowing capacity and speech intelligibility were evaluated by visual analog scale scores (7 points) at 1 to 7 years after surgery, and changes in neotongue volume were examined by dividing volume into 4 stages.The 5-year disease-specific survival rate was 71%. Almost all patients were able to eat a soft diet and resume verbal communication. However, a sufficient volume of the reconstructed tongue was decreased over the course of time. Volume change was more definitive in the cases using the anterolateral thigh free flap than the rectus abdominis musculocutaneous free flap. Neotongue volume was also correlated with swallowing capacity and speech intelligibility.In total tongue reconstruction, wide and thick flaps such as the rectus abdominis musculocutaneous flap had better outcomes. Overcorrection with a sufficient flap volume is recommended for adequate oral intake owing to volume loss caused by radiation therapy, and functional muscle transfer should also be considered to prevent muscle atrophy. Lastly, static suspension procedures are emphasized to prevent airway aspiration for larynx preservation
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00001665-201001000-00024&LSLINK=80&D=ovft
DOI
10.1097/SCS.0b013e3181c46692
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Rah, Dong Kyun(나동균)
Lew, Dae Hyun(유대현)
Yun, In Sik(윤인식) ORCID logo https://orcid.org/0000-0003-1103-7047
Lee, Dong Won(이동원) ORCID logo https://orcid.org/0000-0003-0046-3139
Lee, Won Jai(이원재) ORCID logo https://orcid.org/0000-0003-3056-0503
Choi, Eun Chang(최은창)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100839
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