Functional outcomes and quality of life after partial glossectomy for tongue carcinoma: A prospective observational study.

Abstract

237 Background: Tongue resection for carcinoma significantly impacts essential functions such as speech, swallowing, and tongue mobility. While various reconstruction techniques are available, their comparative impact on long-term function remains inadequately studied, especially within a standardized surgical framework. Methods: This prospective study included 42 patients with T1–T3 squamous cell carcinoma of the tongue who underwent Type II glossectomy at a tertiary cancer center. Patients were stratified into three reconstruction groups: primary closure, MatriDerm-assisted secondary intention healing, and flap reconstruction. Functional outcomes were assessed at 6–12 months postoperatively using validated instruments: EAT-10 for swallowing, Speech Handicap Index (SHI) for speech, Tongue Motility Assessment (TMA), and EORTC QLQ-F17 and HN35 for quality of life. Results: Swallowing outcomes were largely preserved, with a mean EAT-10 score of 3.05. MatriDerm group had the lowest swallowing difficulty, though differences between groups were not statistically significant (p = 0.079). SHI and TMA scores showed significant variation (p = 0.013 and p < 0.001, respectively), with flap reconstructions associated with worse outcomes. RAFF flaps performed better than bulkier options like ALT. Radiotherapy and chemotherapy were significantly associated with poorer function and QoL (p < 0.05). QoL scores were generally good, but subjective perceptions were lower in older patients. Tumor size, stage, and reconstruction type significantly influenced outcomes. Conclusions: MatriDerm and primary closure offered superior functional outcomes in partial glossectomy compared to flap reconstruction, particularly in T1–T2 tumors. The use of a standardized glossectomy classification (Ansarin et al.) enhanced methodological clarity. Future studies should explore long-term outcomes across broader populations and incorporate routine rehabilitative strategies. Clinical trial information: CTRI/2024/03/063482 . Demography of the patient. Clinical Details Mean ± SD || Median (IQR) || Min-Max OR N (%) Age (Years) 56.33 ± 12.00 || 57.50 (48.25-66.50) || 30.00 - 78.00 Surgery Type  PG+ND + Flap Reconstruction 18 (42.9%)  PG+ND + Primary Closure 16 (38.1%)  PG+ND + Matriderm Placement 8 (19.0%) Neck Dissection Type  SOHND 25 (59.5%)  MND 11 (26.2%)  Ext-SOHND 6 (14.3%) Flap Type Used  RAFF Flap 5 (27.8%)  ALT Flap 4 (22.2%)  Infrahyoid Flap 4 (22.2%)  Nasolabial Flap 2 (11.1%)  FAMM Flap 1 (5.6%)  MSAP flap 1 (5.6%)  Submental Flap 1 (5.6%) Post-Operative Hospital Stay (Days) 6.02 ± 2.90 || 5.00 (4.00-7.00) || 3.00 - 13.00 pT Stage  T1 5 (11.9%)  T2 19 (45.2%)  T3 18 (42.9%) pN Stage  N0 19 (45.2%)  N1 9 (21.4%)  N2b 13 (31.0%)  N3b 1 (2.4%) Stage  I 4 (9.5%)  II 8 (19.0%)  III 16 (38.1%)  Iva 13 (31.0%)  IVb 1 (2.4%) Maximum Tumor Dimension (cm) 2.87 ± 1.23 || 2.80 (2.12-3.53) || 0.50 - 5.60 RT (Yes) 33 (78.6%) CT (Yes) 6 (14.3%)