Intelligibility and perceptual characteristics were examined in a bilingual Zulu/Xhosa-speaking patient following glossectomy and mandibulectomy with primary closure and two subsequent reconstruction using osteomyocutaneous flaps. Changes across a twelve-month period were investigated, using intelligibility tests administered to native speakers, lateral view xeroradiography and fiberoptic investigations. Findings emphasise the need for reconstructive surgery to strive for preservation of articulator mobility, relationships between articulators and the positioning of vocal tract constrictions. The possibility of atrophic changes deleterious to speech and a more influential role for the speech therapist are discussed.