Subjective evaluation of postoperative function in patients who had undergone reconstruction after ablation of tongue/floor of the mouth cancer

—A multicenter study through a qestionnaire—

Abstract

Through a multicenter study, we aimed to provide information for the selection of treatment and reconstructive method, and improvement of their postoperative function. This study reports the results of questionnaires about the tongue/floor of mouth cancer patients who had undergone reconstruction with fasciocutaneous/myocutaneous flaps on self-assessment of postoperative function. Eighty-one patients, enrolled from 13 Japanese institutions, were classified into three groups by the site of resection: lateral (N=51), anterior (N=17), and combined (N=13) . The lateral group was divided into three subgroups and the anterior group into two subgroups by the size of resection. Reconstruction was accomplished by radial forearm flap (N=50), rectus abdominis myocutaneous flap (N=18), pectoralis major myocutaneous flap (N=11), and others (N=2) . Postoperative function was evaluated subjectively using 14 selfreporting questionnaires including four categories of speech, eating, and swallowing in oral and pharyngeal phase. The influence of site and size of resection on the functional results was investigated with that of flap. Better results were generally obtained for lateral type resections and smaller excisions. Hemiglossectomized patients in the lateral group reconstructed with a radial forearm flap could speak faster than those repaired with a rectus abdominis myocutaneous flap. Other subjective assessments were influenced by the kind of flap used.
Teaching on nutrition and care of dysphagia are important in all patients because the self assessment scone of such contents decreased postoperatively. A new modality with less functional intervention is needed especially in patients of the combined group.