Does the mandibular lingual release approach impact post-operative swallowing in patients with oral cavity and/or oropharyngeal squamous cell carcinomas: a scoping review

ABSTRACT

Dysphagia is a common consequence following surgical resection of oral cavity and/or oropharyngeal squamous cell carcinoma. Clinical anecdotal evidence suggests significant, long-term swallow compromise may result from following use of the mandibular lingual release approach (MLRA), though there is limited research to guide clinical care. A scoping review of MLRA and swallowing outcomes were conducted (1950–2020). Study quality was rated using the levels of evidence rating tool. Eight studies met inclusion criteria. All were retrospective cohort designs, exploratory in nature and rated as poor quality. Four reported swallow-related outcomes via a patient-reported tool and clinician-rated scale. Poor data specificity prohibited calculations of incidence or mean severity. Three papers hypothesized a link between the division of the digastric musculature and impaired post-operative mastication/swallowing. Current evidence is low quality and limited, restricting understanding of dysphagia post-MLRA. Future studies into the nature, biomechanics and recovery of swallowing are needed to develop care pathways for this population.

KEYWORDS:

• Dysphagia
• deglutition
• swallowing disorders
• head and neck cancer
• mandibular lingual release approach

Acknowledgements

We thank Adele Coleman (Research Assistant, University of Queensland) for her assistance with data extraction and analysis. We also thank Julie Williams (Librarian, St Vincent’s Hospital) for her support with searching for publications.

Disclosure statement

No potential conflict of interest was reported by the author(s).