Speech and swallowing outcomes following glossectomy: a systematic review

Abstract

Objectives Glossectomy has been known for its detrimental effects on quality of life. This systematic review aims to investigate the speech and swallowing outcomes following glossectomy due to oral cancer. Materals and Methods Electronic search on EMBASE, Medline, Pubmed, Scopus and Web of Science was conducted. Manual search was also performed for studies up to January 2021. Included studies were analysed for tumor staging, extent of resection, method of reconstruction, adjuvant treatment, speech and swallowing assessments. Results From an initial yield of 2104 articles, 28 studies were included in the final review. Various subjective and objective measurements were employed. In the early postoperative phase, the decline in functional outcomes was noticeable. Improvements were evident with longer follow-up period. Old age, large primary tumor size, adjuvant therapy and concomitant resection of floor of mouth or mandible resulted in poorer functional recovery. Meanwhile, preservation of the tip of tongue was significantly associated with favourable speech outcomes. To restore bulk and flexibility of the neotongue, multiple flap designs with specific dimensions were suggested for different extents of glossectomy. Conclusion A variety of reconstructive options is available for different extent of glossectomy. Speech and swallowing function may improve over time. Future studies should focus on more objective, standardised and systematic assessment methods to evaluate the factors influencing the functional outcomes and quality of life after glossectomy.