Quality of life, swallowing and speech outcomes after oncological treatment for mobile tongue carcinoma

Background: Surgical treatment of squamous cell carcinoma of the oral cavity (OSCC) has a high impact on patients’ quality of life (QoL), as it variably affects their ability to speak, swallow and their social life. It is still debatable whether free flap tongue reconstruction has significant functional advantages over non-reconstructing techniques after tongue resection. Methods: A case-control retrospective study was performed involving 14 patients who underwent partial glossectomy with or without floor of the mouth resection for OSCC of the mobile tongue. After resection, seven patients were reconstructed with a microvascular free flap, while seven were closed primarily or healed by secondary intention. All patients were asked to fill four questionnaires investigating their quality of life. As objective evaluation of swallowing, each patient underwent a Fiberoptic Endoscopic Evaluation of Swallowing and a videofluoroscopy. Results: Questionnaires showed an optimal global quality of life and high functional outcomes in both groups. The objective evaluation of swallowing showed a prevailing difficulty in the oral phase in both groups, without further swallowing impairment. Our data confirm excellent speech, swallowing and life quality in both microvascular reconstruction and non-reconstructive techniques groups. Conclusions: Acknowledging the limited number of cases, our study showed that speech, swallowing and QoL results are similar both after large tongue defects reconstructed by microvascular free flaps, and small tongue resections managed with non-reconstructive techniques. This further underlines the importance of microvascular free flaps after extended tongue resections. Level of evidence: Level V, therapeutic study.