A Comparative Study of Speech and Swallowing Postoperative Outcomes in Oral Cancer: Impact of Lateral Mandibular Continuity Restoration.

Background: Surgical resection with mandibulectomy in advanced oral cancer results in complex defects. The influence of reconstruction of mandibular continuity on postoperative speech and swallowing function, though crucial, is not widely studied.

Purpose: The purpose of study was to compare the speech and swallowing outcomes of oral squamous cell carcinoma (OSCC) patients with lateral mandibulectomy, with or without the restoration of mandibular continuity.

Study design, setting, sample: This retrospective cohort study was performed at the Malabar Cancer Centre, Kerala, India, on patients who had undergone lateral mandibulectomy for OSCC from January 2016 to December 2021. Patients with recurrent or second primary OSCC, or with psychiatric disorders and cognitive impairment, or in whom any type of glossectomy was done, were excluded from the study.

Predictor variable: The predictor variable was reconstruction status of mandibular continuity, coded as yes when it is restored and no for vice-versa.

Main outcome variable(s): The outcome variables were postoperative speech outcome measured with a 7-point rating speech intelligibility scale and swallowing outcome measured with functional oral intake scale.

Covariates: Covariates included age, sex, tumor subsite, mandibular defect, and adjuvant treatment.

Analyses: Data analyses included χ², Fisher's exact test, independent t test, Spearman's correlation test, and one-way analysis of variance test. P values < .05 were considered statistically significant.

Results: The study sample had 201 patients, with continuity restored in 74 (36.82%) patients and vice versa in 127 (63.18%) patients. The mean age in the continuity restored group was 54.97 ± 9.68 years, and in the continuity not restored group, it was 59.49 ± 9.95 years (P < .05). Both the groups had more male patients (P = .15). The speech scores in both groups at 1 month (P = .66), 3 months (P = .45), and 6 months (P = .33) of postoperative period were compared and had no statistically significant difference. The swallowing scores in groups at 1 month (P = .5), 3 months (P = .5), and 6 months (P = .7) of postoperative period were also compared and had no statistically significant difference.

Conclusion and relevance: Reconstruction of lateral mandibular continuity was not associated with improved postoperative speech and swallowing.