Speech after partial glossectomy: a comparison between reconstruction and nonreconstruction patients.
OBJECTIVE
This study was undertaken to compare the articulation intelligibility of patients after hemiglossectomy or minor glossectomy within the hemitongue with or without reconstruction.


METHODS
The articulation intelligibility of 19 patients who underwent hemiglossetomy or minor glossectomy within the hemitongue was investigated at least 6 months after surgery with an articulation intelligibility test with 40 sensitive Chinese sounds. Patients were divided into group 1 (those undergoing reconstructive surgery after glossectomy) and group 2 (those not undergoing reconstructive surgery after glossectomy). Defects of the tongue (in group 1) were reconstructed immediately with free radial forearm flaps or pedicled flaps after glossectomy and closed primarily without reconstruction in group 2. The articulation intelligibility scores were compared between the 2 groups.


RESULTS
The mean articulation intelligibility score for group 1 was 77.0% (blade portion glossal sounds), 76.3% (mid portion glossal sounds), and 84.7% (rear portion glossal sounds), and those of group 2 were 94.6%, 92.1%, and 95.3%, respectively. The intelligibility of articulation of group 2 was significantly higher than that of group 1 in blade portion glossal sounds (P <.05), mid portion glossal sounds (P <.05), and rear portion glossal sounds (P <.01).


CONCLUSIONS
The articulation intelligibility was better in patients not receiving grafts than in those receiving grafts. Reconstruction with flaps, which may interfere with the flexibility and mobility of the tongue, may contribute to articulatory impairment. If speech is the outcome of interest, reconstruction may be unnecessary with hemiglossectomy or other partial (minor) glossectomy within the hemitongue.
Chuanjun
Chen
C
Department of Oral Maxillofacial Surgery, The 9th Affiliated Hospital, Shanghai Second Medical University, Shanghai, China. ccj6318@sina.com.cn
Zhiyuan
Zhang
Z
Shaopu
Gao
G
Xinquan
Jiang
J
Zhihong
Zhang
Z
D000328:Adult; D000368:Aged; D001184:Articulation Disorders / Q000209:etiology*; D002921:Cicatrix / Q000150:complications / Q000209:etiology; D005260:Female; D005927:Glossectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000009:adverse effects; D013062:Speech Articulation Tests; D013065:Speech Intelligibility; D013524:Surgical Flaps; D014059:Tongue / Q000601:surgery