title: Predictive factors of dysphagia after lateral and superior oropharyngeal reconstruction with free flap transfer.
abstract: OBJECTIVE
  Lateral and superior oropharyngeal reconstruction is technically challenging and can be complicated by postoperative dysphagia. The aim of this retrospective study was to identify the predictive factors of dysphagia after lateral and superior oropharyngeal reconstruction with free flap transfer and to establish better management for cases with these predictive factors.
  
  
  METHODS
  We performed a retrospective chart review of 109 patients who had undergone lateral and superior oropharyngeal reconstruction with free flap transfer for oropharyngeal cancer. Preoperative, operative, and postoperative variables were examined, and possible predicative factors for dysphagia were subjected to univariate analysis and multivariate logistic regression analysis.
  
  
  RESULTS
  Dysphagia occurred in 16 patients (14.7%). Multivariate logistic regression analysis identified extensive tongue base resection, postoperative radiotherapy, and history of radiotherapy to the head and neck region as independent factors contributing to dysphagia after lateral and superior oropharyngeal reconstruction. Of these factors, extensive tongue base resection was the most important.
  
  
  CONCLUSIONS
  Early intervention to minimize the risk of dysphagia should be performed for patients identified with these predictive factors.
authors.affiliation: Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Fujiki
authors.affiliation: Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Tokyo, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Sakuraba
authors.affiliation: Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Shimpei
authors.initials: S
authors.lastname: Miyamoto
authors.affiliation: Division of Head and Neck Surgery, National Cancer Center Hospital East, Chiba, Japan.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D003680:Deglutition Disorders / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: dysphagia; free flap transfer; oropharyngeal reconstruction; radiotherapy; tongue base resection