D49. Patient Reported and Clinical Outcomes after Radial Forearm vs. anterolateral Thigh Free Flap Reconstruction of Glossectomy Defects: A Preliminary Examination

PURPOSE: Patient reported outcome measures such as FACE-Q, are currently being integrated and evaluated in head and neck reconstruction. This study examines clinical and FACE-Q outcomes in patients that underwent oncologic glossectomy reconstruction with radial forearm (RFFF) vs. anterolateral thigh (ALT) free flaps. METHODS: A retrospective review was performed for patients who underwent partial or hemiglossectomy and primary reconstruction with a RFFF or ALT between 2016-2021. FACE-Q is separated into multiple functional and stress domains where higher scores (0-100) represent better outcomes. Postoperative FACE-Q scores were divided into two time periods for comparison: short-term (0-1 year) and long-term (>1 year). The rate of complications that necessitated return to OR was also examined. RESULTS: 88 patients underwent partial or hemiglossectomy reconstruction with a RFFF, while 43 received an ALT. 56 RFFF and 16 ALT patients filled out at least one postoperative FACE-Q. RFFF patients reported significantly higher short-term satisfaction with their smile (p=0.017) and swallowing function (p=0.048). This cohort also reported significantly better long-term satisfaction with facial appearance (p=0.002), function in eating/drinking (p=0.014), and oral competence (p=0.016), as well as significantly less distress with eating (p=0.005) and facial appearance (p=0.014). There was no significant difference in complication rates between the two cohorts. CONCLUSION: The RFFF may perform better than the ALT in multiple PROM domains after reconstruction of glossectomy defects in the short and long-term. Expansion of this study may provide useful information for shared decision making between patients and providers in head and neck reconstruction moving forward.