Postoperative speech function in patients of cancer of floor of mouth with immediate surgical reconstruction

—an oncology group study—

Abstract

The postoperative speech function was assessed with a speech intelligibility test of 100 Japanese monosyllables. The subject was 19 patients with surgical reconstruction after complete ablation of cancer of the floor of the mouth. Among them, the radial forearm flap (FAF) was used in 12 patients, the pectoralis major myocutaneous flap (PMMCF) and the rectus abdominis flap were performed in 3 cases each, and a combination of FAF and PMMCF was in one patient. Concerning removed tongue area, fourteen patients had partial resection of the tongue, one had removal of a half of the oral tongue, one had hemiglossectomy, and 3 had subtotal resection of the tongue. The speech function was analyzed to find out influences of operation factors, such as, size of the tumor, area of tongue resected, operation site, and methods of reconstruction. As a result, there was less relation between sizes of the primary tumor (T-classification), however, the wider the area of resected tongue, the worse the speech function. Patients of cancer of the lateral part of the mouth floor had significantly better speech scores than patients whose cancers were in the anterior part of the mouth. Then, the improvement of operative techniques as well as the prosthetic treatment were proposed to obtain better speech function.