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Quality of life after free-flap tongue reconstruction

Published online by Cambridge University Press:  17 September 2008

D M Hartl ,
S Dauchy ,
C Escande ,
E Bretagne ,
F Janot  and
F Kolb
D M Hartl*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France
S Dauchy
Affiliation:
Department of Oncopsychiatry, Institut Gustave Roussy, Villejuif, France
C Escande
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France
E Bretagne
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France
F Janot
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France
F Kolb
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France
*
Address for correspondence: Dr Dana M Hartl, Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805 Villejuif Cedex, France. Fax: +33 1 42 11 52 73 E-mail: dana.hartl@igr.fr
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Abstract

Objective:

To analyse correlations between quality of life measures, aspiration and extent of surgical resection in patients who have undergone free-flap tongue reconstruction.

Patients and methods:

Nine consecutive patients (seven men and two women; average age 51 years) who had been diagnosed with T4a carcinoma of the mobile tongue and/or tongue base and treated by glossectomy, free-flap reconstruction, and either radiation therapy or chemoradiation responded to the European Organization for Research and Treatment of Cancer Head and Neck-35 questionnaire, the performance status scale questionnaire and the hospital anxiety–depression scale questionnaire, an average of 43 months after treatment (range 18–83 months). Aspiration was evaluated by fibre-optic laryngoscopy. Correlations between quality of life domain scores, extent of surgery and the presence of aspiration were evaluated using non-parametric statistical analysis.

Results:

Scores for the swallowing and aspiration domains of the European Organization for Research and Treatment of Cancer Head and Neck-35 questionnaire were significantly correlated with the extent of tongue base resection (Spearman's correlation, p = 0.037 and 0.042, respectively). Despite a strong correlation between the European Organization for Research and Treatment of Cancer Head and Neck-35 questionnaire results and the performance status scale global scores (correlation coefficient = 0.89, p = 0.048), the performance status scale domain scores were not correlated with the extent of tongue resection. Clinically apparent aspiration was not correlated with the extent of tongue resection, nor were the anxiety or depression scores. However, clinically apparent aspiration was significantly related to the swallowing and aspiration domain scores of the European Organization for Research and Treatment of Cancer Head and Neck-35 questionnaire (p = 0.017 in both cases).

Conclusions:

Our results imply that the volume of tongue base resection is a major factor in swallowing- and aspiration-related quality of life following tongue resection and free-flap reconstruction. Free-flap reconstruction does not seem to palliate the effect of the loss of functional tongue base volume, as regards swallowing-related quality of life.

Keywords

Head and Neck NeoplasmsTongueQuality of LifeReconstructive Surgical Procedures
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 5 , May 2009 , pp. 550 - 554
Copyright
Copyright © JLO (1984) Limited 2008

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