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Long-term functional outcomes after total tongue reconstruction: Consideration of flap types, volume, and functional results

 Woon Hyeok Jeong  ;  Won Jai Lee  ;  Tai Suk Roh  ;  Dae Hyun Lew  ;  In Sik Yun 
 MICROSURGERY, Vol.37(3) : 190-196, 2017 
Journal Title
Issue Date
Adult ; Aged ; China ; Cohort Studies ; Deglutition/physiology ; Female ; Follow-Up Studies ; Free Tissue Flaps/blood supply ; Free Tissue Flaps/transplantation ; Glossectomy/methods ; Graft Rejection ; Graft Survival ; Humans ; Male ; Microsurgery/methods ; Middle Aged ; Myocutaneous Flap/blood supply ; Myocutaneous Flap/transplantation ; Reconstructive Surgical Procedures/adverse effects ; Reconstructive Surgical Procedures/methods* ; Recovery of Function/physiology* ; Retrospective Studies ; Risk Assessment ; Speech Intelligibility ; Statistics, Nonparametric ; Surgical Flaps/blood supply ; Surgical Flaps/transplantation* ; Time Factors ; Tongue Neoplasms/pathology ; Tongue Neoplasms/surgery* ; Treatment Outcome
OBJECTIVE: The purpose of this study is to evaluate the long-term results of flap volume change, swallowing capacity, speech intelligibility, and differences between vertical rectus musculocutaneous (VRAM) and anterolateral musculocutaneous (ALT) free flaps in total tongue reconstruction.

PATIENTS AND METHODS: We retrospectively analyzed the medical records of 31 patients who underwent total tongue reconstruction with VRAM (24 cases) and ALT flap (7 cases). The mean age of patients was 52.09 ± 2.25 years. The tumor types were as follows: squamous cell carcinoma (28 cases), adenoid cystic carcinoma (2 cases), and metastatic cancer (1 case). The flap volume was determined based on clinical and imaging examinations. Swallowing and speech function were analyzed using seven-point rating scales.

RESULTS: All flaps survived eventually after surgery; however, 1 patient underwent VRAM flap experienced partial flap necrosis, wound dehiscence in 4 patients underwent VRAM flap, and infection in 3 patients (VRAM; 2 patients, ALT; 1 patient). The mean follow-up period was 3.97 ± 0.54 years. The volume of the flaps remained relatively constant over time. The swallowing capacity positively correlated with the flap volume (P < 0.0001); however, the speech intelligibility did not correlate with the flap volume in analysis of total cohort. There were no statistical differences in functional outcomes between the two types of reconstructed flaps (P > 0.05).

CONCLUSION: The preservation of flap volume was important to achieve superior swallowing capacity; however, it was insufficient to promote the speech outcome. The functional outcomes did not differ depending on the type of flap. © 2015 Wiley Periodicals, Inc. Microsurgery 37:190-196, 2017.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Roh, Tai Suk(노태석) ORCID logo https://orcid.org/0000-0001-8681-159X
Lew, Dae Hyun(유대현)
Yun, In Sik(윤인식) ORCID logo https://orcid.org/0000-0003-1103-7047
Lee, Won Jai(이원재) ORCID logo https://orcid.org/0000-0003-3056-0503
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