Speech and Swallowing Following Tongue Cancer Surgery and Free Flap Reconstruction-A Systematic Review

Abstract

Introduction-Tongue restoration presents a number of difficulties, including pedicle or free flaps, with variances resulting from the creation of the entire neotongue or the remaining native tongue tissue. Methods: Research on functional outcomes following tongue restoration with flaps was found using a thorough search of Embase, PubMed, the Cochrane Library, and Web of Science. 42 of the 782 articles were reviewed. The Critical Appraisal Skills Program instrument was used by four independent researchers to evaluate bias risk. Results: While free flaps like the radial forearm and anterolateral thigh were commonly utilised, the submental flap was the most common pedicle flap. Rebuilding type, postoperative radiation, and the extent of resection all affected functional results. In terms of functionality, neo-tongue reconstruction was different from oral tongue reconstruction. Speech results were comparable across pedicle and free flaps, while swallow outcomes were better with sensory or motor- innervated flaps. Conclusions: The study’s findings are limited by inconsistent data, retrospective designs, and lack of standardized methods, necessitating cautious interpretation. Free flaps consistently offer better functional outcomes for tongue reconstruction, improving over time with rehabilitation.