The Effect Of Different Reconstructive Methods On Postoperative Tongue Functions In Patients With Early Tongue Cancer

Objective: To study the effect of two different reconstructive methods on postoperative tongue related functions and quality of life in patients with early tongue cancer,and compare the difference of treatment effect between the suture group and the collagen membrane group.Methods: Thirty patients with early tongue cancer(T1 or T2)were randomly and equally divided into the suture group and the collagen membrane group with 15 patients in each one.After the resection of tongue carcinoma,the suture group was sutured directly,while the collagen membrane group was grafted with collagen membrane.Patients were evaluated preoperatively as well as one,three,and six months postoperatively for tongue related functions(tongue movement,swallowing function,and speech function)and quality of life.Tongue movement function was evaluated by measuring the moving distance of the tongue tip.Swallowing function was evaluated by drinking water test,standardized swallowing assessment,and video fluoroscopic swallowing study.Speech function was evaluated by using word table of Chinese articulation test.Quality of life was evaluated by using the University of Washington quality of life questionnaire.Results:(1)There was no statistically significant difference in gender,age,weight,the number of smokers,tumor stage,and lymph node metastasis between two groups.(2)Wound healing of postoperative tongue: The suture group showed obvious scar contraction in the wound with a shortened and deformed tongue.The collagen membrane group healed well with a smooth,elastic,and slightly contracted tongue.(3)There was no statistically significant difference in preoperative tongue movement,swallowing function,speech function,and quality of life between two groups.(4)Comparison of changes on tongue movement function from pre-to post-operation between two groupsAt one month postoperatively,the tongue movement function declined significantly for patients in both groups.At three and six months postoperatively,the tongue movement function gradually recovered and stabilized,but it was worse than the preoperative level.At one month postoperatively,there was no statistically significant difference of the recovery of tongue movement function between two groups.At three and six months postoperatively,except for elevation movement,the collagen membrane group had a better recovery of tongue movement function than the suture group(P＜ 0.05).(5)Recovery trend of postoperative swallowing,speech function,and quality of life,and comparison of pre-to post-operative changes between two groupsAt one month postoperatively,swallowing,speech function and quality of life declined in both groups.At three months postoperatively,functions and quality of life gradually recovered and stabilized,and swallowing function and quality of life were close to the preoperative level.At one,three,and six months postoperatively,there was no statistically significant difference in the recovery of swallowing,speech function and quality of life between two groups.Conclusion:(1)Repairing the tongue wound by direct suture or by collagen membrane did affect tongue related functions and quality of life for patients with early tongue cancer.Both tongue related functions and quality of life declined in the short term after operations,and then gradually recovered and stabilized in the long term.(2)Three months after the operation,the collagen membrane group had a better recovery of tongue movement function than the suture group(P＜ 0.05).(3)Movement function requires different level of tongue mobility and flexibility from swallowing and speech function.Swallowing and speech function do not require the extreme movement of the tongue,which may account for why there was no statistically significant difference of swallowing,speech function,and quality of life in patients with early tongue cancer between two groups.