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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.

Although preservation of speech and swallowing is certainly a desirable goal when repairing soft tissue defects after tumor resection, speech and swallowing are not the only factors that must be considered . . . [Full Text of this Article]