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PubMedDate not supplied

Outcomes of anterior cruciate ligament reconstruction in patients with Workers' Compensation claims.

SUMMARY: A general perception exists that outcomes of orthopaedic procedures in patient's with Workers' Compensation claims fare worse than those of patients without such claims. We retrospectively reviewed the outcomes of anterior cruciate ligament (ACL) reconstruction in patients who have Workers' Compensation claims. This minimum 2-year follow-up study analyzed the occupational, functional, and objective results of patients who underwent arthroscopic-assisted anterior cruciate ligament (ACL) reconstruction. Twenty-two patients with Workers' Compensation claims representing 5% of patients who underwent ACL reconstruction at our institution between 1987 and 1995 were included in the current study. All reconstructions were performed by the senior author (B.R.B.) using arthroscopic-assisted techniques (single and double-incision) with bone-patellar tendon-bone autografts followed by an accelerated rehabilitation protocol. Postoperative follow-up physical examinations revealed a negative anterior drawer in 19 patients (91%), a negative Lachman in 15 patients (68%), and a negative pivot shift in 21 patients (96%). The KT-1000 arthrometric evaluation at follow-up showed a mean maximum manual difference of 1. 9 mm with 15 patients (68%) having a maximum manual difference of </=3 mm and 7 patients (32%) from 3 to 5 mm. The mean postoperative scores for the Hospital for Special Surgery scoring scale was 86, Noyes Sports activity scale 81, Noyes ADL score 36, Noyes Problem with Sports 75, Noyes Sports Function score 87, Lysholm score 82, and the Tegner score 5.9. The Noyes Occupational rating system increased from preoperative 48 to 60 postoperatively and the Noyes Job Title rating system score remained at 5 after surgery. Functional testing revealed mean deficits of no more than 9% between the reconstructed and normal knees. SF-36 testing revealed significantly higher scores in the Role Physical and General Health categories and a significantly lower score in the Mental Health category when compared with United States norms. Subjective evaluation revealed that 95% of the patients would undergo a similar procedure if faced with a similar injury to the contralateral knee in the future. The results of the current study show that ACL reconstruction leads to predictable functional and occupational results in those patients with work-related injuries. All of our patients were able to return to work. The hypothesis that Workers' Compensation compromises the results of ACL reconstruction was not observed in this study.

Accidents, Occupational↗

PubMed1997

The efficacy of regional anesthesia for outpatient anterior cruciate ligament reconstruction.

Arthroscopically assisted anterior cruciate ligament (ACL) reconstruction is a common orthopaedic procedure. Until recently, the majority of these procedures have been performed on an impatient basis. This retrospective study evaluated 67 consecutive patients who underwent an arthroscopically assisted, autogenous bone-patellar ligament-bone ACL reconstruction that was supervised by the same surgeon. General endotracheal anesthesia was used for 36 patients and a femoral sciatic nerve block was used in 31 patients. Only patients who underwent either isolated ACL reconstructions, or those combined with either medial or lateral meniscectomies, were included. No statistically significant differences in either the mean anesthesia time or operative time existed between the general anesthesia and regional anesthesia groups. Patients receiving regional anesthesia did require a significantly longer recovery room stay than those who received general anesthesia. Most of the patients who received general anesthesia had inpatient procedures. In the general anesthesia group, 31 of 36 patients spent at least one night in the hospital. Three of 30 patients who received regional anesthesia required hospital admission. There were no differences between anesthesia-related complication between groups. The cost saving of performing ACL reconstructions under regional anesthesia compared with general anesthesia was calculated to be $2,907 per case and predominantly reflected the outpatient approach used in these cases. This study supports the use of femoral sciatic nerve block anesthesia as a safe and reliable alternative to general anesthesia for patients undergoing outpatient ACL reconstruction. The use of this technique was not found to compromise operating room efficiency. Patients receiving regional anesthesia did require a slightly longer recovery room stay. ACL reconstruction performed under regional anesthesia with same-day discharge was well tolerated by our patients and it provides a cost-efficient alternative to ACL reconstructions performed as inpatient procedures.

Adult↗

PubMedDate not supplied

Wavelet based multiresolution expectation maximization image reconstruction algorithm for positron emission tomography.

Maximum Likelihood (ML) estimation based Expectation Maximization (EM) [IEEE Trans Med Imag, MI-1 (2) (1982) 113] reconstruction algorithm has shown to provide good quality reconstruction for positron emission tomography (PET). Our previous work [IEEE Trans Med Imag, 7(4) (1988) 273; Proc IEEE EMBS Conf, 20(2/6) (1998) 759] introduced the multigrid (MG) and multiresolution (MR) concept for PET image reconstruction using EM. This work transforms the MGEM and MREM algorithm to a Wavelet based Multiresolution EM (WMREM) algorithm by extending the concept of switching resolutions in both image and data spaces. The MR data space is generated by performing a 2D-wavelet transform on the acquired tube data that is used to reconstruct images at different spatial resolutions. Wavelet transform is used for MR reconstruction as well as adapted in the criterion for switching resolution levels. The advantage of the wavelet transform is that it provides very good frequency and spatial (time) localization and allows the use of these coarse resolution data spaces in the EM estimation process. The MR algorithm recovers low-frequency components of the reconstructed image at coarser resolutions in fewer iterations, reducing the number of iterations required at finer resolution to recover high-frequency components. This paper also presents the design of customized biorthogonal wavelet filters using the lifting method that are used for data decomposition and image reconstruction and compares them to other commonly known wavelets.

Algorithms↗

PubMed1992

The effect of infrarenal aortic reconstruction on glomerular filtration rate and effective renal plasma flow.

Compromised patients with aortic disease are vulnerable to various complications from aortic reconstruction. These complications are related to changes in systemic haemodynamics during aortic cross-clamping, which leads to cardiac stress and alteration in regional blood flow to different organs. One of the most important postoperative complications is renal failure which is associated with a high mortality rate. Circulatory alterations within the kidney must play a role in the pathogenesis of renal dysfunction that may follow infrarenal aortic cross-clamping and reconstruction. To study the effects of abdominal aortic reconstruction on renal function and perfusion, we measured prospectively the glomerular filtration rate (GFR, n = 59), effective renal plasma flow (ERPF, n = 38) and left ventricular ejection fraction (LVEF, n = 38) in patients undergoing elective infrarenal aortic reconstruction. Radionuclide techniques were used. The three parameters were measured at three time points: preoperatively, postoperatively and 6 months after surgery. The LVEF was measured in order to reflect the patient's cardiac status and pre-renal perfusion. We also measured the three parameters in two control groups of patients: a group of patients undergoing major colonic surgery and a group of patients with arterial disease under conservative management. Six months after surgery the GFR had decreased in 67% of aortic reconstruction patients. Overall GFR in the aortic reconstruction group decreased by a mean of 9 ml min-1 (p = 0.007). This was associated with a decrease in the ERPF in 48.5% of patients. The mean decrease in ERPF in the aortic reconstruction group was 74 ml min-1 (p = 0.05). The LVEF was unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed2002

Direct reconstruction of the innominate artery.

PURPOSE OF THIS STUDY: Occlusive disease of the innominate artery requiring reconstruction is relatively uncommon. Data concerning these lesions has come from retrospective reviews at larger institutions. The purpose of this paper is to review the most recent experience at the Mayo Clinic, as well as to review the experiences of other large centers in the recent past, and to determine which patients are benefited by direct reconstructions and which patients might be better served by indirect methods or by endovascular techniques. BASIC METHODS: A retrospective analysis of the trends at the Mayo Clinic concerning reconstruction of the innominate artery since 1976 was undertaken. Two reviews from our institution, published in 1989 and 1999, of all patients seen since 1976, were analyzed. This retrospective analysis also included papers from other referral centers dealing with innominate artery reconstruction, both here and in France. PRINCIPAL FINDINGS AND CONCLUSIONS: The great majority of patients with symptomatic disease of the innominate artery are well treated by direct reconstruction. Stroke and death rates are acceptable. Early results are excellent, and the durability of the operation is also excellent, with impressive stroke-free survival rates. There are subsets of patients who might be treated by medical techniques or techniques other than direct reconstruction, such as cervical reconstruction or endovascular repair. Coronary artery disease remains the main determinate of early and late morbidity.

Arterial Occlusive Diseases↗

PubMed1994

Primary mandibular reconstruction with bridging plates.

25 cases in which the mandible was resected and reconstructed using a reconstruction plate (AO titanium reconstruction system and Leibinger titanium reconstruction system) are presented. 16 patients suffered from oral carcinoma, 7 presented with odontogenic tumours and 2 had chronic osteomyelitis of the mandible. The mean age was 54.2 years, the male to female ratio was 2.6:1. 3 patients had a reconstruction plate for mandibular resection without continuity defect (marginal resection), in all the other patients the reconstruction plate bridged a mandibular resection with a continuity defect: 13 were located in the body, body-angle or ascending ramus with preservation of the mandibular condyle; 4 hemimandibulectomies with disarticulation of the TMJ; and 5 involved the anterior arch, crossing the midline. 12 patients received radiotherapy (3 pre-operatively). Only 3 patients with significant local side effects needed the treatment to be stopped for a period of time. There was no perioperative mortality. Only one plate was removed. Although minor complications were noted in 11 patients, the general improvement in the functional and cosmetic balance of the patients when compared with patients in whom no plate was used, justifies the use of this reconstruction system, in our opinion.

Adolescent↗

PubMed1998

Immediate reconstruction after complete skin-sparing mastectomy with autologous tissue.

BACKGROUND: Immediate breast reconstruction with autologous tissue can re-create a breast mound that closely resembles the native breast in shape and consistency. Results are limited by scarring and color differences between flap and native breast skin. This study reviews all patients undergoing complete skin-sparing mastectomy with immediate autologous tissue reconstruction over the past 4 years. STUDY DESIGN: Twenty-eight patients with a mean age of 43 years (range, 32-53 years) were retrospectively reviewed. Requirements for the complete skin-sparing approach included a favorable biopsy scar location, adequate areolar diameter, and suitable donor site for autologous tissue reconstruction. Ninety-two percent of patients were reconstructed with a transverse rectus abdominis musculocutaneous flap. RESULTS: There were no instances of flap loss or local recurrence during the followup period (mean, 27 months; range, 14-48 months). Complications at the reconstruction site were minor and limited to cellulitis, periareolar skin loss, and the need for repeat skin excision because of a very close pathologic margin. Donor site complications were seen in five patients. Aesthetic results were judged as excellent or good in 75% of patients. CONCLUSIONS: Complete skin-sparing mastectomy with immediate autologous tissue reconstruction has enhanced immediate breast reconstruction by reducing scar burden and eliminating color differences without an increased incidence of local recurrence. This procedure is limited by appropriate patient selection and technical expertise in performing the mastectomy.

Adult↗

PubMed2002

Iterative image reconstruction for clinical PET using ordered subsets, median root prior, and a web-based interface.

PURPOSE: The development, implementation and validation of simple, flexible and efficient iterative image reconstruction (IIR) methods for their take-up in routine clinical positron emission tomography (PET) static or dynamic studies. PROCEDURES: The ordered subsets (OS) technique applied for the acceleration of the maximum likelihood expectation maximization (MLEM) IIR algorithm is here extended to include the weighted least-squares (WLS), image space reconstruction algorithm (ISRA) and the space alternating generalized EM (SAGE). The median root prior (MRP) has been successfully applied as a Bayesian regularization to control the noise level in the reconstructed images. All methods are implemented on distributed Pentium systems and tested using simulated PET data from a brain phantom. A Javascript is used for the initiation of the reconstruction. RESULTS: Taking into consideration the image quality and the time required for the reconstruction, the MRP-OSEM (ordered subsets expectation maximization) seems to provide best results after four to eight iterations, with four subsets and a MRP coefficient of 0.2-0.4. Iterative reconstruction of the transmission images with OS-acceleration and MRP regularization with subsequent calculation of the attenuation correction factors (ACFs) is shown to effectively remove streak artifacts in the emission images, especially along paths of high attenuation. CONCLUSIONS: An efficient implementation using distributed processing principles and a web-based interface allows the reconstruction of one frame (with 63 cross-section slices) from a dynamic determination in few minutes. This work showed that regular PC systems can provide fast execution and produce results in clinically meaningful times. This eradicates the argument of the computational burden of the method that prevented the extensive use of IIR in today's modern PET systems.

Journal Article↗

PubMed1999

Iterative X-ray Cone-Beam Tomography for Metal Artifact Reduction and Local Region Reconstruction.

: X-ray cone-beam reconstruction from incomplete projection data has important practical applications, especially in microtomography. We developed expectation maximization (EM)-type and algebraic reconstruction technique (ART)-type iterative cone-beam reconstruction algorithms for metal artifact reduction and local reconstruction from truncated data. These iterative algorithms are adapted from the emission computerized tomography (CT) EM formula and the ART. A key step in our iterative algorithms is introduction of a projection mask and computation of a 3-D spatially varying relaxation factor that allows compensation for beam divergence and data incompleteness. The algorithms are simulated with projection data synthesized from mathematical phantoms. In simulation, the EM-type and ART-type iterative algorithms are demonstrated to be effective for metal artifact reduction and local region reconstruction. They perform similarly in terms of visual quality, image noise, and discrepancy between measured and reprojected data. The EM-type and ART-type iterative cone-beam reconstruction algorithms have potential for metal artifact reduction and local region reconstruction in X-ray CT.

Journal Article↗

PubMed1998

A quantitative evaluation of the three dimensional reconstruction of patients' coronary arteries.

BACKGROUND: Through extensive training and experience angiographers learn to mentally reconstruct the three dimensional (3D) relationships of the coronary arterial branches. Graphic computer technology can assist angiographers to more quickly visualize the coronary 3D structure from limited initial views and then help to determine additional helpful views by predicting subsequent angiograms before they are obtained. METHODS: A new computer method for facilitating 3D reconstruction and visualization of human coronary arteries was evaluated by reconstructing biplane left coronary angiograms from 30 patients. The accuracy of the reconstruction was assessed in two ways: 1) by comparing the vessel's centerlines of the actual angiograms with the centerlines of a 2D projection of the 3D model projected into the exact angle of the actual angiogram; and 2) by comparing two 3D models generated by different simultaneous pairs on angiograms. The inter- and intraobserver variability of reconstruction were evaluated by mathematically comparing the 3D model centerlines of repeated reconstructions. RESULTS: The average absolute corrected displacement of 14,662 vessel centerline points in 2D from 30 patients was 1.64 +/- 2.26 mm. The average corrected absolute displacement of 3D models generated from different biplane pairs was 7.08 +/- 3.21 mm. The intraobserver variability of absolute 3D corrected displacement was 5.22 +/- 3.39 mm. The interobserver variability was 6.6 +/- 3.1 mm. CONCLUSIONS: The centerline analyses show that the reconstruction algorithm is mathematically accurate and reproducible. The figures presented in this report put these measurement errors into clinical perspective showing that they yield an accurate representation of the clinically relevant information seen on the actual angiograms. These data show that this technique can be clinically useful by accurately displaying in three dimensions the complex relationships of the branches of the coronary arterial tree.

Adult↗

PubMed1999

Performance of a Fourier-based program for three-dimensional reconstruction of the mitral annulus on application to sparse, noisy data.

OBJECTIVES: We investigated the accuracy of mitral annular reconstruction from noisy, sparse data typical of three-dimensional (3D) transthoracic echocardiograms. BACKGROUND: Our Fourier-based method for reconstructing the annulus from dense, accurate 3D transesophageal echo (TEE) data has been validated in vitro with four harmonics in the x, y, and z coordinates (4,4,4). METHODS: Thirteen mitral annuli were reconstructed from 'complete' 3D TEE data using four harmonics (4,4,4) and used to measure area, eccentricity. height, perimeter, and interpeak and intervalley distances; these were the 'true values'. To simulate transthoracic echo data, the TEE data sets were reduced evenly and unevenly (randomly). The complete and reduced data sets were used to reconstruct the annuli using three sets of fitting parameters: (4,4,4), (1,1,3), and (1,1,4). The resulting size and shape measurements were compared with true values. RESULTS: Regardless of the fitting parameters used, area, 2D perimeter, and 3D perimeter measurements were more accurate using reconstructions from evenly-reduced than randomly-reduced data sets (p < 0.006), and depended significantly on both data density (p < 0.015 for all) and data distribution (p < 0.02 for all). Perimeter, height, and eccentricity of the reconstructed annuli were more accurately measured using four harmonics (4,4,4). CONCLUSIONS: Mitral annuli can be reconstructed from sparse, noisy data using the (4,4,4) fit if at least 25 points are obtained from evenly distributed imaging planes. These results suggest that detailed analysis of mitral annular size and shape can be made accurately from 3D transthoracic echocardiograms.

Case-Control Studies↗

PubMed2005

Highly variable Northern Hemisphere temperatures reconstructed from low- and high-resolution proxy data.

A number of reconstructions of millennial-scale climate variability have been carried out in order to understand patterns of natural climate variability, on decade to century timescales, and the role of anthropogenic forcing. These reconstructions have mainly used tree-ring data and other data sets of annual to decadal resolution. Lake and ocean sediments have a lower time resolution, but provide climate information at multicentennial timescales that may not be captured by tree-ring data. Here we reconstruct Northern Hemisphere temperatures for the past 2,000 years by combining low-resolution proxies with tree-ring data, using a wavelet transform technique to achieve timescale-dependent processing of the data. Our reconstruction shows larger multicentennial variability than most previous multi-proxy reconstructions, but agrees well with temperatures reconstructed from borehole measurements and with temperatures obtained with a general circulation model. According to our reconstruction, high temperatures--similar to those observed in the twentieth century before 1990--occurred around ad 1000 to 1100, and minimum temperatures that are about 0.7 K below the average of 1961-90 occurred around ad 1600. This large natural variability in the past suggests an important role of natural multicentennial variability that is likely to continue.

Climate↗

PubMed1999

Randomized comparison of prevertebral and retrosternal gastric tube reconstruction after resection of oesophageal carcinoma.

BACKGROUND: After potentially curative resection of oesophageal cancer and prevertebral gastric tube reconstruction, approximately one-quarter of patients develop secondary dysphagia due to locoregional recurrence. In half of them dysphagia can be prevented by using an extra-anatomical reconstruction route. The present randomized study was conducted to compare the technical and functional results after prevertebral and retrosternal gastric tube reconstruction. METHODS: Sixty patients underwent resection of a carcinoma of the oesophagus or gastro-oesophageal junction with curative intent. Subsequently, these patients were randomly allocated to either prevertebral (n = 30) or retrosternal (n = 30) gastric tube reconstruction. Early and late complications and functional results were carefully monitored. RESULTS: Creation of the retrosternal tunnel was not accompanied by any perioperative complications. Postoperative recovery, anastomotic leakage and benign stricture formation were not significantly different between the two groups. Functional results, as measured by scintigraphic gastric emptying, quantitative and qualitative oral food intake, and changes in body-weight were similar in the two groups. CONCLUSION: After subtotal oesophagectomy retrosternal gastric tube reconstruction can be performed easily and safely, and gives functional results similar to those obtained with prevertebral reconstruction. In patients at high risk for developing secondary malignant dysphagia the extra-anatomical route is the reconstruction of first choice.

Adult↗

PubMed2001

Psychological aspects of breast reconstruction: a review of the literature.

AIM: This paper critically examines the research literature relating to the psychological aspects of breast reconstruction. Particular attention is given to the role of specialist breast care nurses in supporting women faced with the decision of whether or not to opt for reconstructive surgery. BACKGROUND: Breast reconstruction is intended to offer psychological benefits (e.g. improvements to quality of life, body image, anxiety and depression) to women treated by mastectomy following diagnosis of breast cancer. METHODS: A literature search was carried out on the PSYCHINFO, MEDLINE and CINAHL databases using the terms "breast reconstruction", "mastectomy", "reconstructive surgery", "breast surgery", "breast implants", "transverse rectus adominis myocutaneous (TRAM) flap" and "Lat-dorsi". Further relevant articles were identified from the reference lists of papers detected by this literature search. Finally, proceedings of recent psychological and surgical meetings were scrutinized to identify any conference papers on this topic. FINDINGS: A thorough search of the existing literature revealed a lack of theoretically based studies examining breast reconstruction in terms of relevant psychological constructs, especially in relation to coping and decision-making. This review highlights the methodological flaws with much of the existing research in this area, in particular the reliance upon retrospective designs and the inappropriate use of randomised controlled trials. Suggestions are given for further research in this topical area. CONCLUSIONS: Existing research into the psychological aspects of breast reconstruction is limited and not sufficiently conclusive to inform changes to policy and the provision of care. More methodologically rigorous research is needed.

Adaptation, Psychological↗

PubMed1997

The in situ architecture of Escherichia coli ribosomal RNA derived by electron spectroscopic imaging and three-dimensional reconstruction.

The structures of the large and small ribosomal subunits of Escherichia coli were reconstructed using spectroscopic electron microscopy and quaternion-assisted angular reconstitution to resolutions of better than 4 nm. In addition, the distributions of phosphorus within these complexes were reconstructed. The three-dimensional reconstruction of the distribution of this atomic element is an extension of microanalysis (in two dimensions) for phosphorus identification and mapping, as a signature of the arrangement of the phosphate backbones of the constituent ribosomal RNAs. The results on both the phosphorus reconstructions and the total reconstructions (protein and ribosomal RNA) reveal several passageways through both subunits. The structures correspond favourably with other independent reconstructions of the whole E. coli ribosome from cryoelectron micrographs and their accompanying models of translation (Frank et al., Nature, 376, 441-444, 1995; Stark et al., Structure, 3, 815-821, 1995). The overall reconstructions in conjunction with the phosphorus (rRNA) distributions are the first to be achieved synchronously for this nucleoprotein complex.

Electron Probe Microanalysis↗

PubMed2001

Reconstructed measurements produced from ultrasound images using a computerized system.

OBJECTIVE: The aim of this study was to evaluate the feasibility and accuracy of reconstructed measurements produced from video-printed ultrasound images. DESIGN: Reproduction of reconstructed measurements using designated software and comparison of the results with regular measurements derived from the same images. SUBJECTS: Seventy regular sonographic examinations of biparietal diameter (BPD) and nuchal translucency (NT) thickness. METHODS: The study included 35 conventional-size (BPD) and 35 small-size (NT) measurements. Each image was measured twice during a dynamic ultrasound examination (regular measurements) and twice using a computerized system (reconstructed measurements). The latter comprised three steps: (i) computerization (computer-generated images by scanning); (ii) calibration (using the scale located alongside the image); (iii) measurement (placing the calipers at the desired points). RESULTS: All images were successfully scanned, and the computer-generated images were of sufficient quality for proper measurement. There was no difference between mean values of regular and reconstructed BPD measurements, 63.9 mm (3.7 mm, SE) and 63.6 mm (3.8 mm, SE), respectively. Similarly, mean values of regular NT measurements were similar to the reconstructed ones, 1.48 mm (0.09 mm, SE) and 1.49 mm (0.09 mm, SE), respectively. Repeated regular BPD and NT measurements exhibited repeatability coefficients of 1.6 mm and 0.4 mm, respectively. These values were smaller than those obtained by repeated reconstructed measurements of 2.1 mm and 0.52 mm, respectively. CONCLUSIONS: Reconstructed measurements of ultrasound video-printed images are feasible, require modest facilities and exhibit more than reasonable accuracy. This option may contribute to medical research, audit, quality control and training, as well as to medico-legal issues.

Feasibility Studies↗

PubMed2002

Reconstruction of the labiomental region with local flaps.

BACKGROUND: Reconstruction of the labiomental area presents certain difficulties, especially in the assessment and selection of the incision lines to obtain the best cosmetic result. Among the factors influencing the selection of a reconstruction technique are the presence of natural folds and creases, skin laxity, and the size, shape, and orientation of the wound. Many operative techniques have been described for the reconstruction of this region. OBJECTIVE: To describe a combination of reconstruction techniques which restore the form, preserve sensation, and provide function of the labiomental region after ablative surgery. METHODS: We present two patients with reconstruction of the labiomental area where it was possible to preserve the vermilion of the lower lip after wide excision. The method of reconstruction constitutes a of modification of the Bernard method and Schuchardt procedure. RESULTS: Satisfactory results were obtained with preservation of the sensitivity of the lower lip, competent lip seal, and avoidance of microstomia, in addition to a good aesthetic appearance. CONCLUSION: The described technique is a preferable technique in patients for whom vermilion of the lower lip should be preserved after wide excision. The technique restores the form, preserves sensation, and provides function-the principles of a successful reconstruction.

Adult↗

PubMed2002

Speech after partial glossectomy: a comparison between reconstruction and nonreconstruction patients.

PURPOSE: This study was undertaken to compare the articulation intelligibility of patients after hemiglossectomy or minor glossectomy within the hemitongue with or without reconstruction. MATERIALS AND METHODS: The articulation intelligibility of 19 patients who underwent hemiglossetomy or minor glossectomy within the hemitongue was investigated at least 6 months after surgery with an articulation intelligibility test with 40 sensitive Chinese sounds. Patients were divided into group 1 (those undergoing reconstructive surgery after glossectomy) and group 2 (those not undergoing reconstructive surgery after glossectomy). Defects of the tongue (in group 1) were reconstructed immediately with free radial forearm flaps or pedicled flaps after glossectomy and closed primarily without reconstruction in group 2. The articulation intelligibility scores were compared between the 2 groups. RESULTS: The mean articulation intelligibility score for group 1 was 77.0% (blade portion glossal sounds), 76.3% (mid portion glossal sounds), and 84.7% (rear portion glossal sounds), and those of group 2 were 94.6%, 92.1%, and 95.3%, respectively. The intelligibility of articulation of group 2 was significantly higher than that of group 1 in blade portion glossal sounds (P <.05), mid portion glossal sounds (P <.05), and rear portion glossal sounds (P <.01). CONCLUSION: The articulation intelligibility was better in patients not receiving grafts than in those receiving grafts. Reconstruction with flaps, which may interfere with the flexibility and mobility of the tongue, may contribute to articulatory impairment. If speech is the outcome of interest, reconstruction may be unnecessary with hemiglossectomy or other partial (minor) glossectomy within the hemitongue.

Adult↗