Analysis of speech and swallowing functions after reconstruction in patients who had radical resection of the tongue and the oral floor

• Published in: JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY Vol. 1; pp. 9 - 20
• Main Authors: Hino, Tsuyoshi, Terada, Nobuhisa, Okamoto, Yoshitaka, Konno, Akiyoshi
• Format: Journal Article
• Language: English
• Published: JAPAN SOCIETY FOR HEAD AND NECK SURGERY 1991
• Subjects: oral floor cancer; postoperative speech and swallowing; tongue cancer
• ISSN: 1349-581X; 1884-474X; 1884-474X
• DOI: 10.5106/jjshns.1.9

Analysis of speech and swallowing functions after reconstruction in patients who had radical resection of the tongue and the oral floor.Konno, Akiyoshi, Hino, Tsuyoshi, Terada, Nobuhisa, Okamoto, Yoshitaka. Degree of articulatory and swallowing disfunctions associated with radical surgery and primary reconsruction were evaluated in 20 patients with tongue cancer and 12 patients with anterior oral floor cancer by measuring swallowing pressure in the pharynx and intelligibility of speech. The following conclusions were obtained . (1) In total glossectomized patients in whom laryngeal suspensatory muscles were resected, primary laryngeal suspension and cricopharyngeal myotomy were absolutely necessary for prevention of aspiration. (2) In total glossectomized patients who also had total laryngectomy, reconstruction of simple wide passway of food was best suited for easiest transit of liquid food from the mouth into the esophagus, although swallowing pressure was almost negligible in the pharynx . (3) In subjects who had more than 2/3 of the tongue resected, ample augmentation of the oral floor by transplantation of voluminous tissue was indicated to improve postglossectomy intelligibility of speech. (4) Postoperative oral function was apparently poor in subjects who had pull-through operation for anterior oral floor cancer compared with those who had tongue cancer of same local extension. This is due to complete loss of bilateral genioglossus muscle function and partial or extensive loss of bilateral hypoglossus muscle function even in T2 cases. For improvement of oral function in these cases, anchorage of resected free edge of genioglossus muscles to the mandible by fascia lata transplantation may be worth trying.