Comparative analysis of the functional results of tongue reconstruction with four kinds of free flaps after radical resection of tongue cancer

Abstract

BackgroundSurgery is still the treatment of choice for tongue cancer. Tongue reconstruction should be performed immediately after extensive resection of the tumor, which will affect the patient's function. The purpose of this study was to investigate the functional evaluation of four different free flaps in tongue reconstruction after a tongue cancer operation. Methods Forty-eight cases of tongue reconstruction with a radial forearm free(RFF flap), anterolateral thigh(ALT) flap, lateral upper arm free(LAF)flap and deep inferior epigastric artery perforator(DIEP)flap from 2014 to 2018 were analyzed. The speech function, swallowing function, tongue flexibility and patients' satisfaction with the donor area was investigated six months after repair. ResultsTwenty-one cases with RFF flaps, 18 cases with ALT flaps, 5 cases with LAF flaps and 4 cases with DIEP flaps showed complete flap survival. Speech function:39.6% of the patients exhibited normal speech, 43.8% of the patients exhibited near-normal speech, the RFF flap group was showed better recovery than did the other three groups ( p =0. 195). The degree of tongue flexibility: 37.5% of the patients with normal postoperative tongue flexibility, 43.6% of the patients with slightly limited tongue flexibility,, 16.7% of the patients with severely limited tongue flexibility, The flexibility of the RFF flap was better than that of the other three groups( p =0. 054). Swallowing function:47.9% of the patients had a regular diet, 33.3% of the patients had soft foods, 16.7% patients receive fluid diet, The RFF flap group showed better recovery than did the other three groups ( p =0. 248). Donor satisfaction: 56.2% of the patients were satisfied, 41.7% of the patients were basically satisfied, 100% of the patients with LAF and DIEP flaps were satisfied. This level of satisfaction was better than that in the RFF and ALT flap groups. ( p =0. 039). ConclusionThe functional recovery of RFF flap in tongue reconstruction after middle and early stage tongue cancer surgery is better. However, ALT flap has been used more frequently for a large number of