Objective: To evaluate the post-operative speech and swallowing functions of tongue cancer patients who underwent subtotal glossectomy and free-flap reconstruction.
Method: We reviewed the data of 14 patients: 6 in whom the lingual defects were reconstructed with anterior lateral thigh （ALT） flaps, and 8 with rectus abdominis myocutaneous （RAM） flaps. The postoperative speech and swallowing functions of ALT and RAM flaps were compared.
Results: The speech outcomes were poorer in two ALT flap patients and one RAM flap patient than in other 11 patients. The ALT flaps performed worse in the production of linguopalatal-linguovelar consonants /k/, /c/ and /ʃ/ than for other sounds because of the lack of flap volume. In contrast, the RAM flap performed worse in the apex of the tongue consonant /r/ than for other sounds. Nevertheless, these 3 patients were able to pronounce 80% of words and had little trouble in their daily life. Swallowing outcomes were satisfactory in both ALT and RAM flaps. All patients ultimately achieved oral feeding without need for a stomach or gastrostoma tube.
Conclusion: Speech and swallowing outcomes following subtotal glossectomy and free-flap reconstruction with both ALT and RAM flaps were satisfactory. Postoperative dysfunction can be reduced if suitable flaps are selected.
