An objective assessment of speech and swallowing following free flap reconstruction for oral cavity cancers.

In this prospective study, eight consecutive patients underwent excision of oral cavity cancer and reconstruction with a microvascular free flap. Six patients had one pre- and two postoperative assessments of speech and swallowing at four to six weeks and four to six months respectively. One patient could not attend for the preoperative assessment and another for the first postoperative assessment. The speech assessment consisted of an intelligibility score and an articulation score. The 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 demonstrated minor swallowing problems preoperatively in one patient. Postoperatively, 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 the overall outlook was good. This information should be of value for preoperative counselling.