Impact of Tongue Tip Reconstruction on Articulatory Performance After Major Tongue Resections: Evidence From a Multicentric Study

BACKGROUND: The anterior tongue is crucial in speech articulation; however, the functional implications of tongue tip resection and reconstruction following glossectomy remain inadequately elucidated. This multicentric study aimed to evaluate the impact of lingual tip reconstruction on postoperative articulatory performance and self-perceived speech outcomes in patients undergoing major tongue resections for oral squamous cell carcinoma (OSCC).

METHODS: A retrospective analysis was performed on 57 patients who underwent hemiglossectomy or extended glossectomy across four tertiary referral centers between 2007 and 2023. Articulatory performance was assessed utilizing selected tests from the Fussi-Cantagallo test and the Speech Handicap Index (SHI). Patients were stratified into two groups based on tongue tip management: Group A, ipsilateral tip resection without reconstruction (contralateral tip preserved); Group B, ipsilateral tip resection with partial tip reconstruction. Comparative analyses and multivariate models examined the associations between reconstructive patterns, articulatory performance, and SHI scores.

RESULTS: In tests 1 and 2, the difference between Groups A and B showed a clear trend towards significance in favor of Group A (p = 0.061). No significant difference was found between the two groups in the other tests. Younger age was independently associated with improved articulatory performance (p < 0.02). No differences were observed in outcomes associated with flap type or adjuvant therapy.

CONCLUSIONS: Omitting apical reconstruction when the contralateral apex remains functional may be associated with superior speech outcomes by preserving residual mobility. A function-oriented reconstruction approach, emphasizing motility rather than morphological symmetry, should be prioritized to enhance postoperative communication quality.