{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T06:52:14Z","timestamp":1773211934044,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The treatment of tongue malignancies frequently produces deficits in feeding, swallowing, and speech intelligibility. These have a significant impact on patients' quality\u2010of\u2010life. Free tissue transfer is the preferred method for reconstructing larger, complex defects, and aims to restore both mechanical and sensory function while protecting the airway. The role of dynamic free flap designs incorporating motor reinnervation remains unclear, particularly in cases with more extensive glossectomy defects. The objective of this systematic review is to evaluate the speech and swallow outcomes of patients undergoing dynamic free flap reconstruction following ablative tongue surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was performed to determine the role of dynamic free flap surgery for functional tongue reconstruction. Searches were conducted in MEDLINE (PubMed), EMBASE, the Cochrane Library, Google Scholar, and included English\u2010language studies from 1980 onward. Search terms included: glossectomy in combination with functional reconstruction and related outcomes. Primary outcome measures were flap compromise, competent swallow, and intelligible speech. A meta\u2010analysis was performed using pooled data from comparative studies. Key data analysis was undertaken to calculate weighted effect sizes using random\u2013effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirteen studies reported on the use of dynamic free flaps for tongue reconstruction. A total of 168 innervated flaps were available for comparison after pooling data. The non\u2010weighted flap failure rate was 1.2% within this cohort. Competent swallow varied from 43% to 100% with a mean value of 80.2%. Rates of satisfactory speech were between 73% and 100% with a mean value of 91.7%. The mean follow\u2010up duration was 21.8\u2009months and ranged between 9.5 and 47.6\u2009months. With further analyses of comparative sub\u2010groups, there was a marked improvement in swallow competency with dynamic flap types over static designs (OR\u2009=\u20094.09, 95% CI: 1.75, 9.58,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current evidence indicates that dynamic free flap designs enhance functional recovery and may benefit both swallow and speech outcomes postoperatively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/micr.70155","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T09:33:00Z","timestamp":1765877580000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Systematic Review and Meta\u2010Analysis of Functional Tongue Reconstruction Using Dynamic Free Flap Designs"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2327-4365","authenticated-orcid":false,"given":"O. V.","family":"Hovav","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Gold Coast University Hospital  Southport Australia"},{"name":"The University of Queensland, Faculty of Medicine Southern Clinical Division, Princess Alexandra Hospital  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6495-3770","authenticated-orcid":false,"given":"D. S.","family":"Sparks","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Gold Coast University Hospital  Southport Australia"},{"name":"The University of Queensland, Faculty of Medicine Southern Clinical Division, Princess Alexandra Hospital  Brisbane Australia"},{"name":"School of Medicine &amp; Dentistry Griffith University  Gold Coast Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Velli","sequence":"additional","affiliation":[{"name":"The University of Queensland, Faculty of Medicine Southern Clinical Division, Princess Alexandra Hospital  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"David","sequence":"additional","affiliation":[{"name":"School of Medicine &amp; Dentistry Griffith University  Gold Coast Australia"},{"name":"University of Sydney The Daffodil Centre, Faculty of Medicine and Health  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Rowe","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Princess Alexandra Hospital  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1785-3985","authenticated-orcid":false,"given":"T.","family":"Read","sequence":"additional","affiliation":[{"name":"The University of Queensland, Faculty of Medicine Southern Clinical Division, Princess Alexandra Hospital  Brisbane Australia"},{"name":"Department of Plastic and Reconstructive Surgery Princess Alexandra Hospital  Brisbane Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,16]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Head and Neck Cancers in Australia","author":"Australian Institute of Health and Welfare","year":"2014"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jicd.12463"},{"issue":"6","key":"e_1_2_11_4_1","first-page":"332","article-title":"Function of the Sensate Free Forearm Flap After Partial Glossectomy","volume":"34","author":"Biglioli F.","year":"2006","journal-title":"Journal of Craniofacial Surgery"},{"issue":"5","key":"e_1_2_11_5_1","first-page":"355","article-title":"Compartmental Surgery in Tongue Tumours: Description of a New Surgical Technique","volume":"31","author":"Calabrese L.","year":"2011","journal-title":"Acta Otorhinolaryngologica Italica"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-015-4386-6"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-199408000-00003"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.coms.2024.07.011"},{"issue":"9","key":"e_1_2_11_9_1","first-page":"719","article-title":"The Impact of Dynamic Tongue Reconstruction Using Functional Muscle Transfer: A Retrospective Review of 94 Cases With Functional Outcome Analysis for Various Glossectomy Defects","volume":"50","author":"Choi J. 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