Neurotization of the radial forearm free flap improves swallowing outcomes in hemiglossectomy defects

• Published in: Head & neck 2023-04, Vol.45 (4), p.798-805
• Main Authors: Marchiano, Emily, Kana, Lulia, Bellile, Emily, Smith, Joshua D., Casper, Keith A., Malloy, Kelly M., Chinn, Steven B., Stucken, Chaz L., Prince, Mark E. P., Chepeha, Douglas B., Rosko, Andrew J., Spector, Matthew E.
• Format: Article
• Language: English
• Subjects: Deglutition; Forearm; Free Tissue Flaps; Head and Neck Neoplasms - surgery; hemiglossectomy; Humans; Multivariate analysis; nerve graft; Nerve Transfer; neurotization of free flap; Oral carcinoma; Oral cavity; Patients; Retrospective Studies; sensate radial forearm free flap; Speech; Squamous cell carcinoma; Swallowing; Tongue Neoplasms - pathology; Tongue Neoplasms - surgery
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.27290

Background We examined the effect of free tissue neurotization on speech and swallowing outcomes for patients undergoing reconstruction of hemiglossectomy defects with a radial forearm free flap (RFFF). Methods A retrospective study was performed in patients with oral cavity squamous cell carcinoma undergoing a hemiglossectomy and reconstruction with a RFFF. Functional outcomes including nutritional mode, range of liquids and solids, and speech understandability were analyzed 1‐year post‐treatment. Results Eighty‐four patients were included in this analysis, 41 of whom had neurotized flaps (49%). No significant differences in demographic or clinical variables were seen between the neurotized and non‐neurotized groups. On multivariate analysis controlling for BMI, flap area, and N‐classification, patients with neurotized flaps were significantly more likely to have normal range of liquids and solids and less likely to have a G‐tube. Conclusions Neurotization of RFFF reconstructing hemiglossectomy defects results in decreased G‐tube dependence and improved range of liquids and solids.