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KMID : 0361020000430101102
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Korean Journal of Otolaryngology - Head and Neck Surgery
2000 Volume.43 No. 10 p.1102 ~ p.1108
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Functional Results of Tongue Reconstruction Using Free Flaps after Total Glossectomy
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선동일/Dong-Il Sun
김민식/이정학/전진하/송치준/조승호/Min-Sik Kim/Jeong-Hank Lee/Jin-Ha Jeon/Chi-Jun Song/Seung-Ho Cho
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Abstract
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Background and Objectives : Total glossectomy and postoperative radiotherapy is the treatment of
choice for advanced carcinoma of the floor of mouth and tongue. But, it has the potential for
causing severe speech impairment and disrupting the deglutition and may cause life-threatening
aspiration. Proper reconstruction is essential for the postoperative functional rehabilitation. The aim
of the present study is to evaluate the oncologic results and the results of speech and swallowing
function tests in patients who were reconstructed using surgical flaps after total glossectomy.
Materials and Methods : We reviewed the medical records of 7 patients who underwent total
glossectomy(Jul. 1995 to Feb. 2000). Modified barium swallow(MBS) according to Longmann's
method1) was done in 5 patients and speech function tests which compreised of
Kim's method,2) Bzoch's Method3) and Allison's
method4) were done in 4 patients.
Results : Six patients were found to e stage T4 primary tumors and one was stage a T3 primary
tumor. The lateral thigh free flap was most commonly was used in five cases. In two cases,
either a rectus abdominis free flap or a radial forearm free flap was used. Six patients received
postoperative radiotherapy. Currently, four patients are completely cured but three developed
recurrence, of whom two have expired and one is living. Six patients regained swallowing and
independent oral alimentation. MBS showed poor intraoral transport but, good propulsive
pharyngeal emptying. Also, they regained intelligible speech. Speech intelligibility was grade 4 in
all patients.
Conclusion : The reconstruction with the free flap after total glossectomy provides considerably
satisfactory functional results in swallowing and speech as well as providing better oncologic
results in advanced tongue cancers.
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