Surgical principles and techniques for functional rehabilitation after oral cavity and oropharyngeal oncologic surgery:

Quantitative Three-Dimensional Ultrasound Imaging of Partially Resected Tongues

OBJECTIVE: We sought to assess the impact of partial lateral glossectomies on tongue function and speech.

STUDY DESIGN AND SETTING: Tongue shapes of 12 patients with lateral tumors of the tongue were recorded with three-dimensional ultrasound before their surgery and two months after. Twelve normal participants served as controls. Speech acceptability was also assessed.

RESULTS: Principal component analyses demonstrated that the flap reconstructions led to a stiffening of the operated side of the tongue. A concavity index and an asymmetry index demonstrated that the glossectomy patients exhibited decreased midsagittal grooving and increased lingual asymmetry. The change in midsagittal grooving correlated moderately with the decrease in speech acceptability.

CONCLUSION: A lateral partial glossectomy affects the tongue's intrinsic deformation, in particular midsagittal grooving and symmetry. This can have a detrimental effect for speech.

SIGNIFICANCE: A lateral resection affects the tongue's symmetry and midsagittal groove. The change in midsagittal grooving correlates with a decrease in speech acceptability.

Analysis of Determinants on Speech Function After Glossectomy

PURPOSE

To determine which of the following factors-type of reconstruction, size of tumor, and site of excision-may influence speech intelligibility after glossectomy.

MATERIALS AND METHODS

The speech intelligibilities of 27 tongue cancer patients who underwent glossectomy within the range of the hemitongue were investigated within 6 months after operation with a speech intelligibility test formed by 100 sensitive Chinese sounds. They were compared according to the following factors: type of reconstruction (forearm flap or adjacent flap); size of tumor (T1, T2, T3); and site of excision (anterior, middle, posterior, or hemi part).

RESULTS

There was no significant difference in speech intelligibility between the forearm flap reconstructed group and adjacent flap reconstructed group (P > .05). There was a significant difference in the result between the T1 and T3 groups (P < .05). The speech intelligibilities of the patients with tumors in anterior tongue or hemitongue were significantly lower than those with tumor in the middle or posterior tongue (P < .05). Patients with preservation of the tip of the tongue or floor of the mouth had higher intelligibilities (P < .05).

CONCLUSION

For the patients after glossectomy within the range of hemitongue, except for the type of reconstruction, the tumor site or excision extent of the tongue followed by the tumor size may be key factors in determining the postoperative articulation intelligibility.