AN OBJECTIVE ASSESSMENT OF SPEECH AND SWALLOWING FOLLOWING FREE-FLAP RECONSTRUCTION FOR ORAL CAVITY CANCERS

In this prospective study, eight consecutive patients underwent excisi on of oral cavity cancer and reconstruction with a microvascular free flap. Six patients had one pre- and two postoperative assessments of s peech and swallowing at four to six weeks and four to six months respe ctively. One patient could not attend for the preoperative assessment and another for the first postoperative assessment. The speech assessm ent consisted of an intelligibility score and an articulation score. T he swallowing assessment consisted of a videofluoroscopic examination. Five patients had an excellent postoperative speech assessment score, two had a moderate and one a poor result. Videofluoroscopy demonstrat ed minor swallowing problems preoperatively in one patient. Postoperat ively, three patients had severe or moderate loss of control of bolus. Significant aspiration was detected in two and mild aspiration in one patient at the second postoperative assessment. The abnormalities of speech and swallowing were minor in the majority of the patients and t he overall outlook was good. This information should be of Value for p reoperative counselling.