title: Primary closure versus radial forearm flap reconstruction after hemiglossectomy: functional assessment of swallowing and speech.
abstract: The authors compared the postoperative speech and swallowing function of six patients who underwent free radial forearm flap reconstruction after hemiglossectomy with that of six control patients who underwent primary closure of the defect. Clinical speech pathologic evaluations included the Fletcher time-to-time maximum repetition rate of syllables, multiple rhyme test, and overall quality and intelligibility of the patients' speech. Evaluation of swallowing included the duration of deglutition, bolus volume, and ingestion rate. Speech quality, including intelligibility and articulation, was better in patients with primary closure. However, the bolus volume and ingestion rate in deglutition were better in those with flap reconstruction. These results suggest that the flap adds bulk, thus improving pharyngeal clearance by maintaining the tongue-to-mouth roof contact that is necessary in the swallowing process. The nonfunctional flap, however, hinders articulation by restricting the mobility of the remaining portion of the normal tongue.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Mackay Memorial Hospital, 92 Chung-San North Road, section 2, Taipei, Taiwan.
authors.forename: Hung-Tao
authors.initials: HT
authors.lastname: Hsiao
authors.forename: Yi-Shing
authors.initials: YS
authors.lastname: Leu
authors.forename: Chang-Ching
authors.initials: CC
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003679:Deglutition; D005260:Female; D005542:Forearm / Q000098:blood supply; D006801:Humans; D008297:Male; D008875:Middle Aged; D013060:Speech; D018709:Statistics, Nonparametric; D013524:Surgical Flaps; D014062:Tongue Neoplasms / Q000601:surgery*; D016896:Treatment Outcome