Functional outcomes after surgical reconstruction of the base of tongue using the radial forearm free flap in patients with oropharyngeal carcinoma

Abstract

Background: Historically, the prevention of functional morbidity after multimodal treatment for squamous cell carcinoma in patients with large base of tongue lesions has been challenging. The purpose of the present research is to report prospectively collected speech and swallowing outcomes for patients with disease that encompassed half or more of the base of tongue. Methods: Speech and swallowing data were gathered at 4 evaluation times that spanned the first year of treatment for 32 patients treated with surgery and adjuvant radiation therapy. Results: Speech intelligibility remained above 90% for most patients. In the early postoperative period, patients with 100% of their base of tongue resected experienced decreased intelligibility, which improved by the half-way mark of the evaluations. The majority of patients resumed normal oral feeding, with those who lacked dentition needing to puree their food. Modified barium swallow studies revealed that only 3 patients aspirated thin liquid at the final evaluation. Five patients used a feeding tube at some point over the year of evaluation. At the final evaluation, only 3 patients required enteral feeding, with 2 of these using the tube in combination with oral feeding and 1 using the tube for primary nutrition. Conclusions: The results of this study suggest that surgical reconstruction of the base of tongue using the radial forearm free flap in patients with large base of tongue lesions can lead to functional speech and swallowing results. © 2007 Wiley Periodicals, Inc. Head Neck, 2007