Analysis of reconstructed oropharynx shape after total glossolaryngectomy reconstruction using a free rectus abdominis musculocutaneous flap

Introduction Restoring oral intake through oropharyngeal reconstruction is vital for patients undergoing total glossolaryngectomy. Despite its importance, research in this area is limited, leaving clinicians with few guidelines. The debate regarding the optimal shape of the reconstructed oropharynx highlights the need for further research. Methods This retrospective study analysed data from 16 consecutive patients who underwent primary reconstruction with a free rectus abdominis musculocutaneous flap after total glossolaryngectomy at the University of the Ryukyus Hospital between April 2015 and March 2022. Parameters assessed included reconstructed oropharynx shape (flat or funnel-shaped), demographics, flap characteristics, postoperative course, and oral intake outcomes. Results Of the 16 patients, 10 had a flat oropharynx, while 6 had a funnel-shaped oropharynx. At 6 months post-surgery, 13 patients resumed oral feeding, while 3 did not. Significant differences were observed between the groups in preoperative body mass index (21.1 kg/m² vs. 17.8 kg/m², Welch's t-test, p=0.035) and days until the first oral intake (34.2 days vs. 19.2 days, Welch's t-test, p=0.01). However, no significant differences were found in oral intake form at 6 months after surgery (Fisher's exact test, p=0.518). Conclusion This study suggests that the shape of the reconstructed oropharynx (flat or funnel-shaped) does not significantly impact long-term postoperative oral intake. These findings provide valuable insights into oropharyngeal reconstruction outcomes after total glossolaryngectomy and offer guidance for future research in this area. Nevertheless, further studies are warranted to elucidate the clinical implications of these findings and to address any limitations of this study, particularly regarding sample size constraints.