Almost all patients with base of tongue cancers treated with primary surgery and reconstructed with a modified radial forearm free flap consistently achieve efficient and safe swallowing postoperatively, Canadian researchers report in the August issue of the Archives of Otolaryngology, Head and Neck Surgery.
As senior investigator Dr. Hadi Seikaly told Reuters Health, "This procedure effectively restores swallowing, speech and quality of life for patients requiring major resections of the tongue."
Dr. Seikaly of Walter C. MacKenzie Health Sciences Centre, Edmonton, Alberta and colleagues note that there is a lack of information on the functional outcome of such procedures.
To investigate further, the team prospectively followed patients who were treated with primary surgical resection and reconstruction with the beavertail modification of radial forearm free flap followed by radiotherapy.
After a follow-up of at least 1 year, 19 of the 20 patients with complete data who were included in the final analysis were able to swallow safely.
Nevertheless, mobility of the base of the tongue was reduced compared to presurgical findings according to videofluoroscopic swallowing study data, but no significant difference was found in pharyngeal wall mobility, and the bulk of the base of the tongue was preserved.
The procedure, the researchers conclude, maintains adequate base of the tongue and posterior pharyngeal wall apposition allowing "structures such as the pharyngeal, oral, and suprahyoid musculature to contract and generate the necessary force to propel the food bolus through the oropharynx, resulting in a safe swallow."
Arch Otolaryngol Head Neck Surg;134:857-864.
