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Reconstructive surgery is often necessary after surgical excision of tongue cancer in order to maintain function (speech, swallowing, eating). Depending upon the volume (amount) of tongue tissue that has been surgically removed, reconstructive surgical procedures to restore the normal surface architecture of the tongue may involve using local tongue flaps or distant flaps (pieces of muscle tissue obtained from a distant site). Examples of distant flaps that may be used in reconstructive tongue surgery include:

• Pectoralis muscle flap
• Latissimus dorsi flap
• Radial forearm flap
• Inferior rectus abdominis flap

Functional outcomes following treatment of tongue cancer depend to a large extent upon the area of the tongue involved (anterior, posterior, or base) as well as the amount of tissue removed at the time of initial surgery.

In general, better functional outcomes can be achieved for tumors involving the anterior two-thirds of the tongue than surgery involving the posterior tongue because the posterior tongue plays a key role in swallowing. Patients who undergo a total or near-total glossectomy may experience major problems with speech, swallowing, and aspiration.

Speech therapy, nutritional counseling, and psychosocial support are critical aspects for helping patients improve their quality of life.