Evaluation of treatment outcome amongst two different treatment modalities for reconstruction of carcinoma of tongue patients: The infrahyoid myocutaneous flap versus radial forearm flap

Harish Saluja; Seemit Vinod Shah; Anuj Dadhich; Shivani Sachdeva

doi:10.4103/njms.njms_122_22

Evaluation of treatment outcome amongst two different treatment modalities for reconstruction of carcinoma of tongue patients: The infrahyoid myocutaneous flap versus radial forearm flap

Natl J Maxillofac Surg. 2023 May-Aug;14(2):226-232. doi: 10.4103/njms.njms_122_22. Epub 2023 Jul 13.

Authors

Harish Saluja¹, Seemit Vinod Shah¹, Anuj Dadhich¹, Shivani Sachdeva²

Affiliations

¹ Department of OMFS, Rural Dental College, Pravara Institute of Medical Sciences, Loni, Maharashtra, India.
² Department of Periodontology, Rural Dental College, Pravara Institute of Medical Sciences, Loni, Maharashtra, India.

Abstract

Introduction: Oral cancer is one of the most common cancers not only in India but also in South Asia. Treatment of oral cancer is not only limited to cure but also requires good reconstruction of the surgical defects for a better quality of the life. There are many well-proven options for reconstruction purposes for the defects of the oral cavity including local regional flaps to microvascular-free flaps. After resections of mobile parts of the tongue (up to 50%) speech and swallowing are impaired significantly, however, even after sophisticated plastic reconstruction, serious swallowing and speech problems persist.

Material and methods: The pilot study was carried out after the allocation of fourteen patients with carcinoma of the tongue into two treatment test groups; the Radial forearm flap (RFF) and Infrahyoid neuromuscular flap (IHF) group to evaluate and compare the treatment outcome for reconstruction using two different treatment modalities. The pilot study was carried out after the allocation of fourteen patients with carcinoma of the tongue into two treatment test groups. the clinical parameters likewise swallowing reflex, speech analysis, donor site complication, time taken for the surgery, and cost-effectiveness of the flap was evaluated using IBM SPSS Statistics for Windows software, 20.0 (IBM Corp., Armonk, USA). The data were numerically coded and entered into the program. Both the descriptive statistics and the inferential statistics involving one-way ANOVA and Tukey's Post Hoc test were analyzed to compare both intergroup and intragroup comparisons at different time intervals.

Results: The swallowing and aspiration analysis showed a highly statistically significant difference at 3 months and 6 months by Post Hoc test between the groups. The speech analysis scores at all intervals were not statistically significant while for tongue movements the results were significant. The time taken and expenditure for surgery by IHF were less in comparison to RFF.

Conclusion: The infrahyoid flap is a quick, easy, and reliable reconstructive method, which is cost-effective when used with knowledge of its clinical utility and limitations, the functional results are excellent with great patient satisfaction.

Keywords: Carcinoma of tongue; infrahyoid flap; tongue reconstruction.