title: Hemiglossectomy tongue reconstruction: Modeling of elevation, protrusion, and functional outcome using receiver operator characteristic curve.
abstract: The purpose of this study was to model >12 month speech and the oral phase of swallowing outcomes with the reconstructive metrics of tongue elevation and protrusion in patients reconstructed with the rectangle tongue template for a hemiglossectomy defect.
  
  
  
  We conducted a study using 40 surviving patients (23 men, 17 women) treated between 2000 and 2012. Statistically significant correlations of elevation and protrusion with functional outcomes were modeled with receiver operator characteristic (ROC) curves to understand the performance and reliability of the rectangle tongue reconstruction.
  
  
  
  Tongue elevation (1.8-1.9 cm) reliably produces best outcomes in nutritional mode, range of liquids, and ≥4/6 for range of solids. Greater tongue elevation (2.1-2.2 cm) reliably produces best outcomes for eating and speaking in public and understandability of speech. Tongue protrusion (0.8-1.0 cm) reliably produces best scores across all assessed outcomes except ≥4/6 for range of solids and ≥4/5 understandability of speech.
  
  
  
  ROC curves are useful for assessing reliability and relating reconstructive objectives to functional outcomes. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1066-1073, 2016.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada.|Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Chepeha
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Spector
authors.affiliation: Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Chinn
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio.
authors.forename: Keith A
authors.initials: KA
authors.lastname: Casper
authors.affiliation: Department of Anesthesiology, University of Florida, Gainesville, Florida.
authors.forename: Eric J P
authors.initials: EJ
authors.lastname: Chanowski
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Moyer
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.
authors.forename: Robert
authors.initials: R
authors.lastname: Morrison
authors.affiliation: Department of Speech-Language Pathology, McLaren Flint Health Care System, Flint, Michigan.
authors.forename: Emily
authors.initials: E
authors.lastname: Carvill
authors.affiliation: Department of Speech-Language Pathology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Teresa H
authors.initials: TH
authors.lastname: Lyden
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003679:Deglutition / Q000502:physiology; D005260:Female; D005927:Glossectomy / Q000379:methods* / Q000534:rehabilitation; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012372:ROC Curve; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D013065:Speech Intelligibility; D013524:Surgical Flaps / Q000637:transplantation*; D014059:Tongue / Q000502:physiology*; D014062:Tongue Neoplasms / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery*
keywords: functional outcomes; hemiglossectomy; oral cavity cancer; speech and swallowing function; tongue reconstruction; tongue squamous cell carcinoma