Recovery of swallowing function following surgery for advanced buccopharyngeal carcinoma Recupero della funzione deglutitoria dopo chirurgia per carcinoma orofaringeo localmente avanzato

SUMMARY More than 20 years have passed since the introduction of surgical techniques based on distal myocutaneous fl aps or microvascular fl aps in the reconstruction after head and neck cancer resections. The experience gained from the beginning of these techniques until today, has improved the possibility to better predict functional impairment of swallowing in patients and its possible recovery. This contributes to a better counselling of the patient and better prediction concerning his/her quality of life. Despite the time passed and good progress in the development of microsurgical techniques, the literature shows that many differences still remain among Authors concerning choice of fl ap and its inset in relation to the anatomical sites and the extent of resection. Many other variables may condition post-operative swallowing (pre- or post-operative radiotherapy, general conditions of the patient …) thus contributing to a more diffi cult comparison of the different series reported in the literature. Personal experience is based upon surgical treatment in >60 patients with advanced bucco-pharyngeal cancer, all of whom evaluated post-operatively by video-endoscopy and video-fl uoroscopy. In summary, data collected both from personal experience and the literature show that diffi culties still remain in correct evaluation of swallowing in these patients. This is mainly due not only to lack of a commonly accepted scheme of classifi cation to quantify the anatomical defect but also to differences between Authors concerning choice of the type of fl ap and the mode of inset.