Effect of tongue reconstruction following hemiglossectomy on articulation and speech intelligibility

This study is aimed to investigate the articulatory functions of patients who have undergone tongue reconstruction following hemiglossectomy. The second aim of the study is to compare the speech intelligibility between hemiglossectomy patients who have undergone tongue reconstruction using pectoralis major myocutaneous with those hemiglossectomy patients who had undergone tongue reconstruction using radial forearm free flap.Fourteen patients who have undergone tongue reconstruction following hemiglossectomy as a treatment for oral cancer between the age of 30 to 60 years were taken up for this study. Tamil Articulation Test was used for assessing the articulatory functions of patients. The speech intelligibility of each patient was assessed using the Ali Yavar Jung National Institute for the Hearing Handicapped intelligibility rating scale. Analysis of articulatory errors revealed linguoalveolar consonants were more impaired when compared to other consonants. Patients with radial forearm free flap had somewhat better speech intelligibility compared to patients with pectoralis major myocutaneous flap reconstruction.The type of reconstruction also impacts the speech intelligibility. Effective intervention can be planned based on the comprehensive speech evaluation and analysis of articulatory error relative to place and manner of production.

Immediate Postoperative Single-Dose Intravenous Ferric Carboxymaltose After Autologous Free-Flap Breast Reconstruction: A Prospective Cohort Study With Propensity Score Matching

Intravenous ferric carboxymaltose (IV-FCM) can effectively correct perioperative anemia in patients undergoing major surgeries. However, its efficacy and side effects in patients undergoing free flap-based breast reconstruction are yet to be investigated. Starting from year 2020, patients with breast cancer undergoing abdominal free flap-based breast reconstruction were injected 500 mg of IV-FCM immediately post-operation. Propensity-matched 82 IV-FCM injected (study group) and 164 historical control group patients were analyzed for transfusion rates, changes in hematological parameters, and flap or donor-site related complications. The major and minor complication rates related to the operation site were similar between the two groups. There was no significant difference in the transfusion rate between the two groups (p = 0.71). However, the total amount of transfusion required was significantly higher in the historical control group (p = 0.02) than in the study group. Additionally, the historical control group showed a significantly higher drop in red blood cell count, hemoglobin, and hematocrit levels from postoperative days 1 to 2 and 2 to 3 compared to the study group. Immediate postoperative use of IV-FCM in free flap-based breast reconstruction was well tolerated by patients, reduced overall transfusion volume, and promoted faster postoperative recovery of hematological parameters.

Quality of life in head and neck cancer patients at 5 years after free flap reconstruction: a significant decline during the follow-up

Purpose Free flap reconstructions following head and neck tumor resection are known to involve more than 50% rate of complications and other adverse events and up to 50% mortality during a 5-year follow-up. We aimed to examine the difference in the long-term quality of life (QoL) between the 2-year and 5-year assessments after free flap surgery for cancer of the head and neck. Methods A total of 28 of the 39 eligible patients responded to the survey. QoL was assessed at 5 years after operation and compared with the assessment performed at 2 years after the operation using RAND-36, EORTC-C30 and H&N-35, and SWAL-QOL tools. Results The criteria for poor QoL using RAND-36 tool was met in 11 (39.3%) patients in contrast to 4 (14.3%, P = 0.003) patients in the 2-year assessment. EORTC-C30 global score was decreased from 83.9 (SD16.4) to 64.6 (SD 24.0, P < 0.001) during the follow-up. In both RAND-36 and EORTC-C30 surveys, decline was found in physical and role functioning together with energy and emotional well-being domains. SWAL-QOL showed poor swallowing-related QoL in both assessments. Conclusion We found a significant decline in QoL during a 5-year follow-up after free flap surgery for cancer of the head and neck.