We applaud McConnel et al1 for their article published in the June 1998 issue of the ARCHIVES in which they tried to quantify speech and swallowing outcomes after various forms of wound closure in patients with defects related to head and neck cancer. Such an evaluation is definitely needed to determine how effectively we are treating our patients and to justify various treatment regimens. However, we think that there were some significant errors in the design of the study and some omissions that must be considered in relation to the authors' conclusion that primary closure of a defect of the oral tongue or base of the tongue results in a better outcome regarding speech and swallowing than flap closure.
Reece GP, Kroll SS, Miller MJ, Evans GR, Chang DW, Langstein HN, Robb GL, Wang B, Goepfert H. Functional Results After Oropharyngeal Reconstruction: A Different Perspective. Arch Otolaryngol Head Neck Surg. 1999;125(4):474-476. doi: