The comparison of the functional outcomes between primary closure and reconstruction with free flap after resection of T1 stage tongue cancer: A prospective study

2020 ◽  
Author(s):  
Ajit Kumar Pathak ◽  
Xiaoshan Wu ◽  
Rong Yang ◽  
Huang Long ◽  
Yafei Xiong ◽  
...  
Keyword(s):  
Prospective Study ◽  
Free Flap ◽  
Functional Outcomes ◽  
Primary Closure ◽  
Tongue Cancer ◽  
T1 Stage ◽  
Time Periods ◽  
Tongue Mobility ◽  
Alt Flap ◽  
Better Than

Abstract Background: Reconstruction with free flap after the resection of tongue cancer is commonly used by craniofacial surgeons. However, it is unknown whether the reconstruction with free flap is better than the primary closure for the T1 stage tongue cancer. The objective of this prospective study is to compare the functional outcomes between these two methods.Methods: In this prospective study, 30 patients who were diagnosed as T1 stage tongue cancer (on anterior -two third of the tongue) were randomly divided into two groups. The first group underwent the primary closure after the resection (15 patients) and the second group were reconstructed with the anterolateral perforator flap (15 patients). All patients underwent postoperative functional evaluation using specific questionnaires and a screening test with special emphasis on speech, swallowing, and tongue mobility at 1, 3, 6 and 12 months.Results: Functional outcomes, including tongue mobility, speech, and swallowing, were all better in primary closure than anterolateral thigh flap group. At 1-month post-op, the speech understandability of the patients who received a primary closure were statistically better than those who received ALT flap (p = 0.01), while at 1-year post-op, there was no significantly different on speech understandability between two groups (p = 0.16). Statistically significant differences were found between the two groups in the swallowing capacity at all four different time periods (p < 0.05). For the primary closure group, tongue mobility was statistically better at all four different time periods than in ALT flap group (p < 0.05).Conclusion: For the tongue cancer patients (T1), reconstruction with primary closure, rather than with flap, can reserve more functions including tongue mobility, speech and swallowing outcomes, and therefore might be the appropriate reconstruction method after partial glossectomy.

Ablation of advanced tongue or base of tongue cancer and reconstruction with free flap: Functional outcomes

2006 ◽  
Vol 32 (3) ◽  
pp. 353-357 ◽  
Author(s):  
C.Y. Chien ◽  
C.Y. Su ◽  
C.F. Hwang ◽  
H.C. Chuang ◽  
S.F. Jeng ◽  
...  
Keyword(s):  
Free Flap ◽  
Functional Outcomes ◽  
Tongue Cancer ◽  
Base Of Tongue

Comparative analysis of the functional results of tongue reconstruction with four kinds of free flaps after radical resection of tongue cancer

2020 ◽  
Author(s):  
yongcong cai ◽  
Chao Li ◽  
Dinfen Zeng ◽  
ChunYan Shui ◽  
RongHao Sun ◽  
...  
Keyword(s):  
Tongue Cancer ◽  
Free Flaps ◽  
Radical Resection ◽  
The Other ◽  
Swallowing Function ◽  
Donor Area ◽  
Tongue Reconstruction ◽  
Alt Flap ◽  
Normal Speech ◽  
Better Than

Abstract Background Surgery is still the treatment of choice for tongue cancer. Tongue reconstruction should be performed immediately after extensive resection of the tumor, which will affect the patient's function. The purpose of this study was to investigate the functional evaluation of four different free flaps in tongue reconstruction after a tongue cancer operation. Methods Forty-eight cases of tongue reconstruction with a radial forearm free(RFF flap), anterolateral thigh(ALT) flap, lateral upper arm free(LAF)flap and deep inferior epigastric artery perforator(DIEP)flap from 2014 to 2018 were analyzed. The speech function, swallowing function, tongue flexibility and patients' satisfaction with the donor area was investigated six months after repair. Results Twenty-one cases with RFF flaps, 18 cases with ALT flaps, 5 cases with LAF flaps and 4 cases with DIEP flaps showed complete flap survival. Speech function:39.6% of the patients exhibited normal speech, 43.8% of the patients exhibited near-normal speech, the RFF flap group was showed better recovery than did the other three groups ( p =0. 195). The degree of tongue flexibility: 37.5% of the patients with normal postoperative tongue flexibility, 43.6% of the patients with slightly limited tongue flexibility,, 16.7% of the patients with severely limited tongue flexibility, The flexibility of the RFF flap was better than that of the other three groups( p =0. 054). Swallowing function:47.9% of the patients had a regular diet, 33.3% of the patients had soft foods, 16.7% patients receive fluid diet, The RFF flap group showed better recovery than did the other three groups ( p =0. 248). Donor satisfaction: 56.2% of the patients were satisfied, 41.7% of the patients were basically satisfied, 100% of the patients with LAF and DIEP flaps were satisfied. This level of satisfaction was better than that in the RFF and ALT flap groups. ( p =0. 039). Conclusion The functional recovery of RFF flap in tongue reconstruction after middle and early stage tongue cancer surgery is better. However, ALT flap has been used more frequently for a large number of tissue defects caused by radical resection of tongue cancer in the advanced stage. Meanwhile, LAF and DIEP flaps can provide a sufficient tissue volume, a conceal scar, fewer complications in the donor area, and both function and beauty, which are easily accepted by patients.

Preliminary Functional Outcomes and Quality of Life after Tongue Reconstruction with the Vastus Lateralis Myofascial Free Flap

2021 ◽  
Author(s):  
Armando De Virgilio ◽  
Andrea Costantino ◽  
Raul Pellini ◽  
Gerardo Petruzzi ◽  
Giuseppe Mercante ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck ◽  
Free Flap ◽  
Functional Outcomes ◽  
Vastus Lateralis ◽  
Life Questionnaire ◽  
Donor Area ◽  
Tongue Reconstruction ◽  
Eortc Qlq

AbstractThe aim of the present study is to report our preliminary experience with the vastus lateralis myofascial free flap (VLMFF) for tongue reconstruction according to tongue and donor site functional outcomes. Twelve consecutive patients (F: 5; median age: 54.0 years, interquartile range or IQR 42.75–69.0) were included. The validated European Organization for Research and Treatment of Cancer of the Head and Neck 35 Quality of Life Questionnaire (EORTC QLQ-H&N35) and the performance status scale for head and neck cancer (PSS-HN) questionnaires were used to assess the health-related quality of life (HRQOL). The lower extremity functional scale (LEFS) was used to self-report the donor area function. All patients were successfully treated, and no VLMFF failure was detected during a median follow-up period of 10.5 months (IQR: 6.5–33.0). The HRQOL showed a median EORTC QLQ-H&N35 score of 56.0 (IQR: 50.0–72.5). The median PSS-HN score was 80.0 (IQR: 45.0–95.0), 75.0 (IQR: 62.5–100.0), 75.0 (IQR: 62.5–100.0) for “Normalcy of Diet,” “Public Eating,” and “Understandability of Speech,” respectively. The self-reported function of the lower extremities (donor area) showed a median LEFS of 59.0 (IQR: 32.5–74.0). This study reports optimistic data regarding the functional and quality of life outcomes after tongue reconstruction using VLMFF. Prospective controlled studies are needed to demonstrate advantages and disadvantages when compared with other reconstructive techniques.

Five-Year Prospective Roentgen Stereophotogrammetric and Clinical Outcomes of the BioPro MTP-1 Hemiarthroplasty

2021 ◽  
pp. 107110072110613
Author(s):  
Vinay V. Balesar ◽  
Lennard A. Koster ◽  
Bart L. Kaptein ◽  
Stefan B. Keizer
Keyword(s):  
Prospective Study ◽  
Clinical Outcomes ◽  
Condition Number ◽  
Clinical Assessment ◽  
Functional Outcomes ◽  
Metatarsal Bone ◽  
Migration Patterns ◽  
Patient Questionnaires

Background: Mixed results for functional outcomes and long-term fixation have been reported for first metatarsophalangeal arthroplasty. This prospective study was designed to evaluate the migration of the BioPro metatarsophalangeal-1 (MTP-1) joint hemiprosthesis with Roentgen stereophotogrammetric analysis (RSA). Migration patterns of the prosthesis, prosthesis-induced erosion of the metatarsal bone, and clinical outcomes were evaluated sequentially to 5 years postoperation (PO). Methods: Eleven female patients received the BioPro-1 hemiprosthesis. Prosthesis translation and metatarsal erosion were measured with RSA at immediately PO, 6 weeks, and 3, 6, 12, 36, and 60 months postoperatively. Clinical assessment was done by patient questionnaires. Results: RSA data of 9 patients were available for analysis. Median (range) number of markers used in RSA analysis, condition number, and mean error of markers around the prosthesis were 4 (3-7), 320 (208-862), and 0.13 (0.02-0.28), respectively. Progressive subsidence was seen up to 3 years PO (mean 2.1 mm, SE 0.32). Progressive metatarsal erosion was found from 1 year PO (mean 0.49 mm, SE 0.15). Pain, function, and quality scores improved after surgery and did not deteriorate at later follow-up moments. Conclusion: Model-based RSA of the BioPro-1 prosthesis shows nonstabilizing medial and distal translation and metatarsal erosion. Despite the measured migration and erosion, clinical outcomes improved and remained similar up to 5 years postoperation.

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