The radial forearm free flap and pectoralis major flap: comparison of their usage for tongue reconstruction following partial glossectomy

AIM: This study compared the functional and morphological results, donor site morbidity, and patient satisfaction after resection for tongue cancer and reconstruction using the pectoralis major flap (PMF) or radial forearm free flap (RFF). METHODS: Twenty-five patients with squamous carcinoma of the tongue who underwent a full-thickness partial glossectomy and reconstruction using a PMF or RFF, and with a follow-up of more than one year were included in the study. Clinical and quality-of-life outcomes were assessed by patient examination and with the aid of a questionnaire. RESULTS: The oral function scores were higher for patients reconstructed with RFF compared with PMF. The RFF group had significant better outcomes concerning tongue mobility (p<0.01), speech (p<0.01), and mouth opening (p<0.01). They also had better oral competence (p<0.01) and swallowing (p<0.05). Patients with advanced cancer, who required more extensive removal of the extrinsic muscles of the tongue, and the floor of the mouth, had poorer functional outcomes with both reconstruction methods. Donor site morbidity did not differ between the two groups. Better extra-oral results were observed using RFF. CONCLUSION: This case series shows that the functional outcome of tongue cancer surgery relies on the reconstruction method used. Though different adverse factors, related to extent of the primary disease or unfavourable local conditions, may affect the outcomes, RFF seems to offer more predictable results and a more expeditious return to normal life than PMF does.