Abstract
In this study, we analyzed the chronological change of speech function during a five-year period in myocutaneous flap volume and tongue movement of a patient with subtotal glossectomy using intraoral inspection, speech intelligibility test and ultrasonographic examination.
A 50-year-old male with diagnosis of tongue cancer classified as T3N0M0 received neoadjuvant radiotherapy, subtotal glossectomy, modified neck dissection, and reconstruction using a rectus abdominis myocutaneous flap. The postoperative course of the patient was uneventful. However, speech therapy was provided for this patient since he complained of speech difficulties. A tongue function examination including speech intelligibility test was performed at 4 months, 1 year 2 months, 2 years 5 months and 5 years 4 months post-operatively. Tongue movement was observed with ultrasonography at 2 years 5 months and 5 years 4 months post-operatively.
As a result, although a reduction in the volume of the myocutaneous flap was obvious, the total speech intelligibility improved at 1 year 2 months compared to 4 months post-operatively, and the improvement was maintained. The intelligibility of the anterior tongue sounds worsened, but the intelligibility of the posterior tongue sounds improved over time. As ultrasonographic findings, reduction in flap volume, disappearance of unstable movement, decrease in tongue movement during vowel production and increase in upward and forward tongue movement were observed at 5 years 4 months compared to 2 years 5 months.
These results suggest that despite the decrease in flap volume, the speech intelligibility was improved and maintained stably by acquisition of approximately normal speech function.
