Functional results of speech and swallowing after oral microvascular free flap reconstruction.
OBJECTIVE
To study speech and swallowing in patients who underwent microvascular free flap reconstruction after major surgery of the oral cavity.


METHODS
Twenty patients, 17 men and 3 women, with a mean age of 58.5 years (range 27-79 years) were included in the study. Squamous cell carcinoma was the most common malignancy. Swallowing assessment was performed through videofluoroscopy, using three consistencies of barium meal. The recorded swallows were assessed for the ability to hold the bolus during the oral phase, lip seal, tongue movement, residue in the floor of the mouth, laryngeal penetration and aspiration. Speech function regarding intelligibility and articulation was objectively assessed.


RESULTS
Fifteen out of 20 patients (75%) had a good lip seal. Fourteen patients (73.6%) had adequate control of bolus, while in 89.4% the neotongue motility was satisfactory. Vallecular residue was noted in 25% of patients, laryngeal penetration in two (10%), while three patients (15%) continued to have significant aspiration, which necessitated continuous feeding through a gastrostomy. Postoperative speech intelligibility and articulation was satisfactory in 75 and 62.5% of the patients, respectively.


CONCLUSIONS
Microvascular free flap reconstruction of major defects after oral resections rehabilitates the functions of swallowing and speech in acceptable levels, improving quality of life in these patients.
Archontaki
Maria
M
Department of Head and Neck/Maxillofacial Surgery, Greek Anticancer Institute, St. Savvas Hospital, 171 Alexandras Avenue, Athens, Greece. marchontaki@web.de
Athanasiou
Athanasios
A
Stavrianos
Spyros D
SD
Korkolis
Dimitris P
DP
Faratzis
Gregory
G
Papadopoulou
Flora
F
Kokkalis
Georgios
G
Rapidis
Alexander D
AD
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D003680:Deglutition Disorders / Q000175:diagnosis*; D005260:Female; D005471:Fluoroscopy; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D015203:Reproducibility of Results; D013064:Speech Disorders / Q000175:diagnosis*; D013524:Surgical Flaps / Q000098:blood supply*; D014741:Video Recording