INTRODUCTION:In the GORTEC 2016-02 SANTAL randomized trial, patients at intermediate-to-high risk of relapse underwent postoperative radiotherapy ± cisplatin. This ancillary study aimed to evaluate the adequacy of surgery and operative reporting of salivary gland carcinomas (SGC). MATERIALS AND METHODS:An independent post-hoc analysis of operative and pathological reports was undertaken for 87 patients with salivary gland carcinomas treated at 26 French centers. Surgical quality was assessed with respect to REFCOR guidelines. The quality of operative reporting was investigated. For both, deviations were classified as major, minor, or absent. RESULTS:Parotid tumors accounted for 53% of cases, submandibular 15%, and minor salivary glands 32% with 37% of adenoid cystic carcinomas. Total or extended parotidectomy was performed in 90.5% of parotid cases, and neck dissection in 70%. Operative reports were rated as adequate in 72% of cases, with 14% minor and 14% major deviations. The rates of inadequate surgical reporting varied between study centers. Surgical procedures were concordant with REFCOR guidelines in 62% of cases, or rated as minor deviations in 22%, 1% as not assessable, and 20% as major deviations, the latter by inadequate neck management or inadequate revision surgery after R2 resection. Quality of reporting by center was correlated with conformity of surgery. Deviations were well balanced between the two trial arms. CONCLUSION:Deviations from standardized surgical reporting and from REFCOR surgical guidelines were observed. These may influence postoperative radiotherapy planning; their impact on patient outcomes remains to be determined.

Case description A 70 year-old woman presenting T4aN2cM0 laryngeal carcinoma first underwent total laryngectomy with airway reconstruction by cryopreserved aortic allograft. Six months after chemoradiotherapy, she underwent endoscopic surgery to create a neo-laryngopharynx. Results At 13 months after primary surgery, day- and night-time breathing was effectively restored, with a little persistent salivary false passage, and a whispering but comprehensible voice after tracheostomy closure. Swallowing was possible for small amounts of soft food, thanks to sustained rehabilitation, although normal feeding was not achieved. The patient showed no episodes of pneumopathy. General health status was good, with no oncologic relapse. Discussion This was the first case of laryngeal replacement by cryopreserved aortic allograft, showing progress in the decades-long aim of final tracheostomy closure. The ultimate objective is to achieve swallowing without false passage, by improving various aspects of surgical technique,without, so far as possible, making the procedures more complex by active airway protection systems.

Salivary carcinomas of minor salivary glands are very infrequent tumors. When located in the tongue, the therapeutic strategy may comprise upfront surgery, which may be debilitating, and/or (chemo-)radiotherapy. The aim of this study was to identify the prognostic factors of salivary carcinomas of the tongue in a population-based cohort. This retrospective multicentric study, based on the "Réseau d'Expertise Français sur les Cancers ORL Rares" (REFCOR), included all the patients with a salivary carcinoma of the tongue, diagnosed between January 2009 and December 2018. Dubious slides were reviewed by REFCOR expert pathologists to ensure diagnostic accuracy. Treatment was performed in accordance with national REFCOR recommendations. From 28 centers, 103 patients were included in this study. Median age at diagnosis was 63 years, and 60.2% were female. Tumors were adenoid cystic carcinomas (41.7%), mucoepidermoid carcinomas (30.1%), and other adenocarcinomas (28.2%). Primary treatment was surgical for 61.2% of them. Five-year overall survival (OS) and event-free survival (EFS) rates were 84.7% and 38.6%, respectively. In multivariable analysis, EFS was significantly worse in case of nonsurgical treatment, alcohol consumption, and glossotonsillar sulcus involvement. N-positive status was the only significant prognostic factor for OS in multivariable analysis. Salivary carcinomas of the tongue represent a heterogeneous group of rare tumors, with a high risk of recurrence. In this national cohort, surgery was associated with better EFS and N-status was the main independent prognostic factor for OS.

Objectives The management of the facial nerve (FN) is a major issue in parotid cancer, especially when there is no preoperative facial palsy and FN invasion is discovered intraoperatively. The aim of this study was to assess the impact of FN resection in patients with parotid cancer abutting the FN, without pretreatment facial palsy, using a propensity score matching. Materials and methods Data from all patients treated between 2009 and 2020 for a primary parotid cancer abutting or invading the FN but without pretreatment facial palsy were extracted from the national multicentric REFCOR database. Three different definitions of tumors abutting the FN were used for sensitivity analyses, in a retrospective setting. Propensity score matching was used to assess the impact of FN resection on disease-free survival (DFS), overall survival (OS) and locoregional recurrence-free survival (LRRFS). Results A total of 163 patients with parotid cancer abutting or invading the FN without pretreatment facial palsy were included. Among them, 99 patients (61 %) underwent FN resection. After overlap weighting and multiple imputation, no benefit of FN resection over preservation was found in terms of OS (HR = 1.21, p = 0.6), DFS (HR = 0.88, p = 0.5) and LRRFS (HR = 0.99, p = 1).Sensitivity analyses revealed similar results, and no significant efficacy was found in the subgroup analyses. Conclusion In this retrospective study with propensity score analysis, FN resection did not improve survival outcomes in patients without preoperative facial palsy treated surgically for a primary parotid cancer abutting the FN. In line with recent guidelines, the results of this study suggest that FN preservation should be considered whenever possible in this specific group of patients.

OBJECTIVES:To analyse prognostic factors and survival outcomes of malignant tumors of the external auditory canal, to investigate the role of regional surgery, and adjuvant radiotherapy in early stages and to investigate the role of surgery in operable T4 stage.SETTING:A retrospective analysis was conducted on all patients prospectively included in the national database of the French Expertize Network for Rare ENT Cancers (REFCOR) from January 2000 to December 2016.PARTICIPANTS:103 patients from 19 reference centers were included. A propensity score matching analysis was applied to enable comparisons between treatments.MAIN OUTCOMES AND MEASURES:Event-free survival, overall survival and factors of poor prognosis of the cohort were described. The interest of local and regional surgery and postoperative radiotherapy were evaluated.RESULTS:The factors of poor prognosis on event-free survival were immunosuppression (p = 0.002), Karnofsky status less than 90% (p = 0.02), body mass index less than 19 Kg / m2 (p = 0.0009), peripheric facial palsy (p = 0.0016), and positive margin (p = 0.0006). In early stages, locoregional surgery was associated with an increase in event-free survival (p = 0.003, HR = 0.21) versus local surgery alone, while postoperative radiotherapy was not associated with an increase in event-free survival (p = 0.86, HR = 0.91) or overall (p = 0.86, HR = 0.91). In locally advanced stages, locoregional surgery followed by radiotherapy was associated with an increase in event-free survival (p = 0.03, HR = 0.39) and overall (p = 0.02, HR = 0.34) versus chemoradiotherapy alone.CONCLUSION AND RELEVANCE:Regional surgery is recommended for early stages of cancers of the external auditory canal. In operable cases, locoregional surgery followed by radiotherapy is recommended.

Retrograde cricopharyngeal dysfunction (RCPD) syndrome renders patients unable to belch, causing disabling symptoms that impact quality of life. Injection of botulinum toxin into the cricopharyngeal muscle has been reported as a trial treatment for both therapeutic and diagnostic purposes. We describe the injection technique, under general anesthesia using endoscopy or by transcutaneous injection with electromyographic control.

(1) Background: Epiregulin (EREG) is a ligand of EGFR and ErB4 involved in the development and the progression of various cancers including head and neck squamous cell carcinoma (HNSCC). Its overexpression in HNSCC is correlated with short overall survival and progression-free survival but predictive of tumors responding to anti-EGFR therapies. Besides tumor cells, macrophages and cancer-associated fibroblasts shed EREG in the tumor microenvironment to support tumor progression and to promote therapy resistance. Although EREG seems to be an interesting therapeutic target, no study has been conducted so far on the consequences of EREG invalidation regarding the behavior and response of HNSCC to anti-EGFR therapies and, more specifically, to cetuximab (CTX); (2) Methods: EREG was silenced in various HNSCC cell lines. The resulting phenotype (growth, clonogenic survival, apoptosis, metabolism, ferroptosis) was assessed in the absence or presence of CTX. The data were confirmed in patient-derived tumoroids; (3) Results: Here, we show that EREG invalidation sensitizes cells to CTX. This is illustrated by the reduction in cell survival, the alteration of cell metabolism associated with mitochondrial dysfunction and the initiation of ferroptosis characterized by lipid peroxidation, iron accumulation and the loss of GPX4. Combining ferroptosis inducers (RSL3 and metformin) with CTX drastically reduces the survival of HNSCC cells but also HNSCC patient-derived tumoroids; (4) Conclusions: The loss of EREG might be considered in clinical settings as a predictive biomarker for patients that might undergo ferroptosis in response to CTX and that might benefit the most from the combination of ferroptosis inducers and CTX.

Background Immune checkpoint inhibitors of programmed cell death protein 1 (PD-1) represent a significant breakthrough in treating head and neck squamous cell carcinoma (HNSCC), with long-lasting responses and prolonged survival observed in first- and second-line therapy. However, this is observed in < 20% of patients and high primary/secondary resistance may occur. The primary objective of the identification of predictive factors for the response to anti-PD-1 immunotherapy in head and neck squamous cell carcinoma (IPRICE) study is to identify predictive factors of response to anti-PD-1 immunotherapy. Methods The IPRICE study is a single-center, prospective, non-randomized, open-label, and interventional clinical trial. Liquid and tumor biopsies will be performed in 54 patients with recurrent/metastatic (R/M) HNSCC undergoing anti-PD-1 immunotherapy alone to compare the evolution of gene expression and immunological profile between responders and non-responders. We will use a multidisciplinary approach including spatial transcriptomics, single seq-RNA analysis, clinical data, and medical images. Genes, pathways, and transcription factors potentially involved in the immune response will also be analyzed, including genes involved in the interferon-gamma (IFN-γ) pathway, immunogenic cell death and mitophagy, hypoxia, circulating miRNA-mediated immunomodulation, cytokines, and immune repertoire within the tumor microenvironment (TME). With a follow-up period of 3-years, these data will help generate effective biomarkers to define optimal therapeutic strategy and new immunomodulatory agents based on a better understanding of primary/secondary resistance mechanisms. Tumor biopsy will be performed initially before the start of immunotherapy at the first tumor assessment and is only proposed at tumor progression. Clinical data will be collected using a dedicated Case Report Form (CRF). Discussion Identifying predictive factors of the response to anti-PD-1 immunotherapy and optimizing long-term immune response require a thorough understanding of the intrinsic and acquired resistance to immunotherapy. To achieve this, dynamic profiling of TME during anti-PD-1 immunotherapy based on analysis of tumor biopsy samples is critical. This will be accomplished through the anatomical localization of HNSCC, which will allow for the analysis of multiple biopsies during treatment and the emergence of breakthrough technologies including single-cell RNA sequencing (scRNA-seq) and spatial transcriptomics. Trial registration Clinicaltrial.gov. Registered April 14, 2022, https://www.clinicaltrials.gov/study/NCT05328024 .

BackgroundDeconvoluting the heterogenous prognosis of Human Papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OSCC) is crucial for enhancing patient care, given its rapidly increasing incidence in western countries and the adverse side effects of OSCC treatments.MethodsTranscriptomic data from HPV-positive OSCC samples were analyzed using unsupervised hierarchical clustering, and clinical relevance was evaluated using Kaplan-Meier analysis. HPV-positive OSCC cell line models were used in functional analyses and phenotypic assays to assess cell migration and invasion, response to cisplatin, and phagocytosis by macrophages in vitro.ResultsWe found, by transcriptomic analysis of HPV-positive OSCC samples, a ΔNp63 dependent molecular signature that is associated with patient prognosis. ΔNp63 was found to act as a tumor suppressor in HPV-positive OSCC at multiple levels. It inhibits cell migration and invasion, and favors response to chemotherapy. RNA-Seq analysis uncovered an unexpected regulation of genes, such as DKK3, which are involved in immune response-signalling pathways. In agreement with these observations, we found that ΔNp63 expression levels correlate with an enhanced anti-tumor immune environment in OSCC, and ΔNp63 promotes cancer cell phagocytosis by macrophages through a DKK3/NF-κB-dependent pathway.ConclusionOur findings are the first comprehensive identification of molecular mechanisms involved in the heterogeneous prognosis of HPV-positive OSCC, paving the way for much-needed biomarkers and targeted treatment.

Head and neck squamous cell carcinomas (HNSCCs) are heterogeneous tumors, well known for their frequent relapsing nature. To counter recurrence, biomarkers for early diagnosis, prognosis, or treatment response prediction are urgently needed. miRNAs can profoundly impact normal physiology and enhance oncogenesis. Among all of the miRNAs, the miR-30 family is frequently downregulated in HNSCC. Here, we determined how levels of the 3p passenger strands of miR-30a and miR-30e affect tumor behavior and clarified their functional role in LA-HNSCC. In a retrospective study, levels of miR-30a-3p and miR-30e-3p were determined in 110 patients and correlated to overall survival, locoregional relapse, and distant metastasis. miR-30a/e-3p were expressed in HNSCC cell lines and HNSCC patient-derived tumoroids (PDTs) to investigate their effect on tumor cells and their microenvironment. Both miRNAs were found to have a prognosis value since low miR-30a/e-3p expression correlates to adverse prognosis and reduces overall survival. Low expression of miR-30a/e-3p is associated with a shorter time until locoregional relapse and a shorter time until metastasis, respectively. miR-30a/e-3p expression downregulates both TGF-βR1 and BMPR2 and attenuates the survival and motility of HNSCC. Results were confirmed in PDTs. Finally, secretomes of miR-30a/e-3p-transfected HNSCC activate M1-type macrophages, which exert stronger phagocytic activities toward tumor cells. miR-30a/e-3p expression can discriminate subgroups of LA-HNSCC patients with different prognosis, making them good candidates as prognostic biomarkers. Furthermore, by targeting members of the TGF-β family and generating an immune-permissive microenvironment, they may emerge as an alternative to anti-TGF-β drugs to use in combination with immune checkpoint inhibitors.

Le stenosi dell’ipofaringe e della bocca dell’esofago sono legate principalmente all’ingestione di prodotti caustici, al trattamento radioterapico per il cancro della testa e del collo o a una storia di chirurgia faringolaringea. Si manifestano con una disfagia che altera la qualità della vita dei pazienti e influenza la loro vita sociale. La gestione chirurgica è complessa, con un alto rischio di recidiva. Questo intervento viene eseguito da diversi specialisti: oto-rino-laringoiatri, chirurghi viscerali, chirurghi plastici, gastroenterologi e radiologi interventisti. Il trattamento di riferimento è la dilatazione sotto controllo endoscopico o videofluoroscopico mediante candele di Savary-Gilliard o palloncino. Può essere posizionato uno stent in caso di stenosi recidivante o di stenosi refrattaria alle dilatazioni, con un’efficacia limitata e un rischio di recidiva al momento della rimozione. Un’iniezione di tossina botulinica può essere necessaria in caso di disturbi della muscolatura cricofaringea. I trattamenti endoscopici come la miotomia dello sfintere esofageo superiore o la sezione della stenosi sono considerati in caso di stenosi persistente. Questi trattamenti possono essere ripetuti o combinati in caso di recidiva. La chirurgia faringoesofagea per via esterna viene presa in considerazione dopo il fallimento di trattamenti meno invasivi e pone il problema della ricostruzione per migliorare la deglutizione senza interferire con la fonazione e la respirazione. Sono possibili lembi fasciocutanei, muscolocutanei o viscerali. Il coinvolgimento esofageo deve essere valutato prima dell’intervento. Si tratta di interventi chirurgici importanti con un rischio significativo di complicanze dovuto alla vicinanza dei nervi ricorrenti e del torace e alla frequenza degli episodi di radioterapia.

Objectives: Sinonasal undifferentiated carcinoma (SNUC) is a rare and aggressive disease requiring multimodal treatment, and multiple new entities once included in the spectrum of SNUC, such as SWI/SNF-deficient carcinomas, are emerging. We aimed to provide new data regarding the role of chemotherapy and surgery and the prognostic factors of disease-free survival. Methods: This study was based on data from the REFCOR database and included patients with SNUC treated with curative intent from 2007 to 2021 across 22 centres in France. Results: A total of 80 patients were included in the analysis. Among the entire cohort, the 5-year disease-free survival (DFS) and overall survival (OS) rates were 58% and 63%, respectively. Of 100% of the patients treated with irradiation, 29% underwent surgery, 56% neoadjuvant chemotherapy (82% had either a partial or a complete response) and 76% chemoradiotherapy. No treatment modality was associated with a better OS or DFS, including surgery (p = 0.34). There was a trend for a better DFS for the patients treated with chemotherapy (neoadjuvant or concomitant, p = 0.062). Overall survival at 3 years was 58% for SWI/SNF deficient group and 86% for non deficient group (p = 0.14). The locoregional relapse rate without distant metastases was 21% in the exclusive radiotherapy group and 26% in the surgery group. Grade 3 or higher toxicities concerned 9%, 32% and 29% of patients for surgery, radiotherapy and chemotherapy respectively. Conclusion: In the management of localised SNUC among all patients treated with irradiation, surgery yielded no benefit, whereas the addition of chemotherapy tended to improve disease-free survival.

INTRODUCTION:Laryngeal chondrosarcoma (LCS) is a rare tumor of slow evolution whose treatment is poorly codified. For a long time, a radical treatment by total laryngectomy (TL) was proposed. More recent studies tend to propose a conservative surgical approach of the larynx. The objective of this study was to compare the overall survival (OS) of total laryngectomized patients (TL+) versus non-laryngectomized patients (TL-). The secondary objectives were to analyse the reoperation free survival (RFS), the total laryngectomy free survival (TLFS) and to identify the preoperative factors leading surgeons to propose TL. MATERIALS AND METHODS:A retrospective analysis of prospectively collected incident cases from the REFCOR and NetSarc-ResOs multicenter databases between March 1997 and June 2021 was conducted. A propensity score matching analysis was performed to compare the OS of TL+ and TL-patients. RESULTS:74 patients were included. After propensity score, the 5-year OS of TL+ and TL-patients was comparable (100 %, p = 1). The 5-year RFS rate was 69.2 % (95 % CI [57.5-83.4]) and the 5-year TLFS was 61.7 % (95 % CI [50.4-75.5]). Cricoid involvement greater than 50 % (HR 3.58; IC 95 % [1.61-7.92] p < 0.001), an ASA score of 3 or 4 (HR 5.07; IC 95 % [1.64-15.67] p = 0.009) and involvement of several cartilages (HR 5.26; IC 95 % [1.17-23.6] p = 0.04) are prognostic factors for TL. Dyspnea caused by the tumour is a prognostic factor for reoperation (HR 2.59; IC 95 % [1.04-6.45] p = 0.03). CONCLUSION:These results demonstrate that conservative treatment should be considered as first-line treatment for laryngeal chondrosarcoma.

Background: Salvage total glossectomy (TG) or total glosso-laryngectomy (TGL) remain controversial, as highly morbid procedures. The objective was to describe oncological and functional outcomes after salvage TG or TGL. Methods: We performed a multicenter retrospective study, including patients with previous neck irradiation undergoing TG or TGL for squamous cell carcinoma involving the base of tongue. Results: We included 42 patients: 27 in the TG group and 15 in the TGL group. For the entire cohort, median OS and DFS were estimated at 19 months (95% IC [14-44]) and 10 months (95% IC [7-13]) respectively, with no difference between the two groups. After a median follow-up of 90 months, 10 patients (24%) were alive and free of disease. Att he end of follow-up, we noted a gastrostomy dependency of 89% and 87 %respectively in the TG and TGL group, and 48% of patients in the TG group had a tracheotomy. Conclusion: Although local control is difficult to achieve after salvage TG or TGL, these procedures are associated with acceptable survival and chance of cure for a last-resort situation. TG and TGL can be proposed in selected motivated patients after careful shared decision-making.

Abstract Background Dysphonia is a frequent comorbidity of asthma and has been suggested to be a local side effect of inhaled corticosteroids due to laryngeal candidiasis. We hypothesized that dysphonia in asthmatics was not due to laryngeal organic lesions but to laryngeal dysfunction during phonation (LDP). Objective We compared the frequency of LDP in female asthmatic patients treated with inhaled corticosteroids to female controls. Methods We compared 68 asthmatic female patients to 53 female control subjects. Pulmonary function tests were performed and the asthmatic patients classified according to the level of inhaled corticosteroids. Dysphonia was defined as a Vocal Handicap Index ≥18 or GRBAS score ≥2. All patients underwent video laryngo‐strobe examination, analyzed blindly and separately by two otolaryngologists, describing mucosal changes, LDP, or Organic lesions linked to Laryngeal Dysfunction during Phonation (OLDP). Results 66.2% of the asthmatic patients exhibited dysphonia and 11.3% of controls (p < 0.001). No laryngeal candidiasis was found, only 3 patients presented laryngeal mucosa inflammation. LDP was observed in 60.3% of asthmatic patients and 18.9% of controls (p < 0.001), and no difference was found for OLDP (11.8% vs. 13.2%). No association was made between LDP, the dosage of inhaled corticosteroid, and bronchial obstruction. Conclusions Asthmatic patients were more dysphonic than control subjects. This phenomenon was not explained by mucosal inflammation, laryngeal candidiasis or OLDP. Asthmatic patients had more LDP than controls. There was no relation between LDP, inhaled corticosteroids dosage or bronchial obstruction. These results change our view of inhaled corticosteroid side effects in female asthmatic patients.

Purpose To evaluate the value of diffusion-weighted imaging and dynamic contrast-enhanced MRI for the diagnosis of parotid gland tumors. Methods Retrospective review of patients with surgically treated parotid tumors between January 2009 and June 2020, who underwent a preoperative parotid gland MRI including standard morphological sequences, diffusion-weighted echoplanar imaging with apparent diffusion coefficient measurement and T1-weighted gadolinium-enhanced dynamic MRI sequences with Fat Saturation. The lesion was classified between malignant vs benign and precisions regarding its histological type were given when possible. Imaging findings were compared with pathology results. Results Inclusion of 133 patients (mean age: 53 years). Multiparametric MRI had a sensitivity of 90.3%, a specificity of 77.5%, an overall accuracy of 80.5%, a positive predictive value of 54.9% and a negative predictive value of 96.3% to differentiate benign parotid tumor from malignant ones. Specificity (85.5%) and positive predictive value (67.6%) were improved for cases, where anatomical and functional MRI characteristics were conclusive and consistent with clinical findings. Conclusions Combining diffusion-weighted and gadolinium-enhanced dynamic sequences, in addition to morphological ones enables high (> 90%) sensitivity to detect malignant parotid gland tumors. It also gives the possibility to characterize pleomorphic adenomas and Warthin tumors and to avoid fine-needle aspiration in cases of typical imaging presentation and reassuring clinical findings.

Purpose The aim of the survey was to define the indications for preventive tracheostomy in transoral robotic surgery (TORS) for head and neck cancers. Methods From October 2019 to January 2020, an online questionnaire was e-mailed to French surgical ENT teams with considerable experience of the TORS procedure (Gettec group). A descriptive analysis of the answers was performed. Results Eighteen French surgical teams answered the questionnaire. For 77.8% of the surgical teams, a past history of radiotherapy with residual edema was an indication for prophylactic tracheostomy, and for 88.9%, > 75 mg of antiplatelet medication or anticoagulation treatment was an indication. Conclusion Early preventive tracheostomy during TORS can protect airway from uncommon but potentially life-threatening complications, such as transoral hemorrhage or airway edema. We recommend it in high-risk situations, such as a past history of radiotherapy or antiplatelet therapy associated with large resections. Further studies are needed to establish evidence-based recommendations.

L’objectif de cette étude est d’évaluer les résultats fonctionnels de la reconstruction mandibulaire par lambeau libre osseux en termes de déglutition, de la parole et de l’esthétique. Enquête transversale multicentrique incluant 134 patients opérés d’une reconstruction mandibulaire par lambeau libre osseux sur 9 centres entre 1998 et 2016, avec un recueil minimum de 6 mois. Un questionnaire standardisé a recueilli les caractéristiques des patients et du traitement réalisé. Les critères de jugement étaient : perte de poids, ouverture buccale, gastrostomie, type de régime alimentaire, reprise de l’alimentation orale et score DHI. L’impact des caractéristiques des patients sur ces critères a été recherché par analyse uni/multivariée. Quatre-vingt-dix patients/134 étaient opérés pour cancer, majoritairement par lambeau fibulaire (80 %). Quatre-vingt quatorze pour cent des reconstructions étaient des succès primaires. Soixante et onze pour cent des patients étaient en contexte post-radique. Quatre-vingt-huit pour cent des patients avaient une exérèse linguale limitée. Quatre-vingt-dix-sept pour cent des patients ont repris une alimentation orale. Quatre-vingt-neuf pour cent des patients ont une voix intelligible. Quatre-vingt-six pour cent évaluent leur aspect esthétique comme moyen ou bon. Neuf pour cent des patients ont bénéficié d’une réhabilitation prothétique. La radiothérapie et l’étendue de l’exérèse linguale influencent significativement la fonction de déglutition (p = 0,04 ; p = 0,03 respectivement). La radiothérapie et l’extension à l’oropharynx influencent significativement la dépendance à une gastrostomie (p = 0,04 ; p = 0,02 respectivement). Les patients reconstruits par lambeau libre osseux retrouvent en majorité une alimentation orale. Plus de 80 % d’entre eux sont satisfaits en termes d’élocution et d’esthétique. Cependant, le taux de réhabilitation dentaire reste faible et les complications fréquentes.