Analysis of Factors for Satisfying Functional Outcomes in Tongue Reconstruction.

Hong, Hyun Joon; Lee, Won Jai; Lew, Dae Hyun; Rah, Dong Kyoon; Tark, Kwan Chul

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2008;35(3):255-260.
Published online May 1, 2008.

Analysis of Factors for Satisfying Functional Outcomes in Tongue Reconstruction.

Hyun Joon Hong, Won Jai Lee, Dae Hyun Lew, Dong Kyoon Rah, Kwan Chul Tark

Institute for Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea. pswjlee@yuhs.ac

Abstract

PURPOSE
Tongue cancer is the most common malignant tumor of the oral cavity and the ultimate goal in treatment of the cancer is not only complete excision and meticulous closure of the wound, but also, reconstruction of a demensional and functional tongue. Our study focuses on various factors, such as defect size, extent of tumor, age, application of mandibulectomy or radiotherapy, and their influences on postoperative speech and swallowing function. METHODS: Our study was based on 59 patients who underwent tongue cancer operation and reconstruction of the tongue. Speech and swallowing were evaluated according to categories documented by Sultan and Teichgraeber. Patients were classified into 3 groups as partial glossectomy, hemiglossectomy and total glossectomy groups for evaluation. The average age of the patients were 51, and the mean follow-up period was 4 years 2 months.
RESULTS
The partial glossectomy group showed statistically relevant results for speech articulation and swallowing abilities compared to the total glossectomy group. In cases of defects involving the mouth floor, the group showed decreased results compared to the group without mouth floor involvement. Increased age showed decreased postoperative results with statistical significance, while mandibulectomy and radiotherapy revealed no statistically significant data. Analysis according to TNM staging resulted in decreased functional result with advanced staging without statistical significance.
CONCLUSION
To summarize the factors influencing the functional outcome in tongue reconstruction, younger patients and early stage cancer with minimal surgical extent revealed more satisfying results while mandibulectomy and radiation did not have influence on our analysis. Addition of various influencing factors and studies with longer follow up periods on our patient groups may provide effective data for more satisfying functional outcomes in the future.

Keywords: Speech; Swallowing; Tongue reconstruction

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