scholarly journals Effect of tongue reconstruction following hemiglossectomy on articulation and speech intelligibility

Author(s):  
V Monish ◽  
V Jaya ◽  
R Johnsi Rani

This study is aimed to investigate the articulatory functions of patients who have undergone tongue reconstruction following hemiglossectomy. The second aim of the study is to compare the speech intelligibility between hemiglossectomy patients who have undergone tongue reconstruction using pectoralis major myocutaneous with those hemiglossectomy patients who had undergone tongue reconstruction using radial forearm free flap.Fourteen patients who have undergone tongue reconstruction following hemiglossectomy as a treatment for oral cancer between the age of 30 to 60 years were taken up for this study. Tamil Articulation Test was used for assessing the articulatory functions of patients. The speech intelligibility of each patient was assessed using the Ali Yavar Jung National Institute for the Hearing Handicapped intelligibility rating scale. Analysis of articulatory errors revealed linguoalveolar consonants were more impaired when compared to other consonants. Patients with radial forearm free flap had somewhat better speech intelligibility compared to patients with pectoralis major myocutaneous flap reconstruction.The type of reconstruction also impacts the speech intelligibility. Effective intervention can be planned based on the comprehensive speech evaluation and analysis of articulatory error relative to place and manner of production.

2008 ◽  
Vol 23 (2) ◽  
pp. 43-45
Author(s):  
Rodney Oliver J. Aragon ◽  
Samantha Soriano –Castaneda ◽  
Joselito F. David

Objective: To present a case of tongue reconstruction using radial forearm free flap. Methods: Design: Case Report Setting:  Tertiary government hospital Patient: One Results: A 52-year- old female with a T3N2cM0 Stage IVa right tongue carcinoma underwent tracheotomy, right hemiglossectomy with modified radical neck dissection type III and extended supraomohyoid neck dissection on the left with radial forearm free flap reconstruction. After 1 month, the radial forearm free flap reconstruction in the tongue had acceptable appearance and good tongue mobility with intelligible speech. The patient did not complain about the appearance and function of the left forearm. Conclusion: The radial forearm free flap is a viable reconstructive option for tongue defects especially where a thin, pliable flap is needed. There is acceptable form and functional restoration with minimal donor site morbidity. Keywords: radial forearm free flap, tongue reconstruction


2003 ◽  
Vol 128 (3) ◽  
pp. 412-418 ◽  
Author(s):  
Wan-Fu Su ◽  
Yi-Jan Hsia ◽  
Yen-Chine Chang ◽  
Shyi-Gen Chen ◽  
Hwa Sheng

OBJECTIVE: Numerous patients in Taiwan with tongue carcinoma require tongue reconstruction. We compared the abilities of 2 methods of tongue reconstruction to reserve tongue function. STUDY DESIGN AND SETTING: Sixty patients underwent resection of the tumors and reconstruction with a pectoralis major flap or a radial forearm flap. The Chinese articulation test was used to evaluate the place and manner of error production, and a questionnaire on dietary habits was used to evaluate deglutition 6 months to 10 years after reconstruction. RESULTS: Patients with the free flap had more intelligible speech. The questionnaire study showed no significant difference between the 2 groups in swallowing rating. Motility caused by flap pliability increased speech intelligibility more than it did on swallowing function. CONCLUSION: Our experience in a few selected patients shows that the functional outcome of tongue surgery is related to the reconstruction methods used (for speech) and to the extent of tongue resection (for swallowing).


Author(s):  
Patrik Pipkorn ◽  
Jake J. Lee ◽  
Joseph Zenga ◽  
Michael R. Chicoine

Abstract Objectives While most defects after endoscopic endonasal resections can be closed with local or locoregional options, rare cases require free tissue transfer. In this setting, while minimally invasive techniques have been described, the essential procedural details are lacking. The objective of this report is to describe several key technical modifications to free flap harvest and endoscopic-assisted inset which decrease morbidity and improve reliability and efficiency. Methods A retrospective chart review was performed of consecutive patients treated at Washington University in St. Louis with endoscopic free flap reconstruction through a Caldwell–Luc/transbuccal approach between January 2016 and September 2019. Results A total of six patients underwent adipofascial radial forearm free flap with this technique, five for recalcitrant cerebrospinal fluid leak or pneumocephalus and one for osteoradionecrosis. All flaps survived and there were no flap-related complications. Five patients (83%) achieved successful healing and separation of the sinonasal cavity and intracranial space. One patient developed recurrent pneumocephalus. Three key technical modifications were identified that improve efficiency and reliability of flap delivery and inset: (1) use of an adipofascial radial forearm flap, without skin paddle; (2) wide resection of the anterior and lateral maxillary face to facilitate flap delivery; and (3) precise defect measurement and flap contouring prior to inset to prevent any need to debulk the flap in situ. Conclusion Endoscopic adipofascial radial forearm free flap delivered to the skull base through a Caldwell–Luc/transbuccal corridor is a feasible option with a high success rate and low morbidity when other reconstructive attempts have failed.


2008 ◽  
Vol 118 (7) ◽  
pp. 1157-1163 ◽  
Author(s):  
Patricio Andrades ◽  
Stephen F. Pehler ◽  
Christopher F. Baranano ◽  
Jeffery S. Magnuson ◽  
William R. Carroll ◽  
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