(0640) English Versus Spanish Proficiency Affecting Quality of Life Following Head and Neck Free Flap Reconstruction

Introduction: Patients who have free flap reconstructive surgery of head and neck defects often experience impairment in their quality of life (QOL). Studies have observed inferior locoregional control among limited English-proficient (EP) patients receiving treatment for head and neck cancer (HNC). There is no study that assesses the effects of English versus Spanish proficiency on patient-reported QOL outcomes following HNC reconstruction.

Methods: Patients having previous HNC free flap reconstruction presenting to our clinic between 2022 and 2024 were administered the University of Washington QOL survey in English or Spanish, depending on the preferred language indicated in the electronic medical record. A retrospective analysis of survey results was conducted comparing total QOL scores in those who were EP versus those who were Spanish-proficient (SP). We compared scores for each survey response within 4 distinct time frames: 0-41 days (immediate postoperative), 42-100 days (adjuvant), 101-365 days (post-adjuvant), and 366-730 days (annual). Two-sample t-tests and ANOVA (p < 0.05) were used to compare the means for each language group across each phase.

Results: In total, 46 patients met inclusion criteria. Of them, 22 patients were EP, and 24 were SP. Among all patients, chewing, speech, and taste means were reported to be the lowest within the first 2 years. In the immediate postoperative phase, SP patients reported less pain (p = 0.006) and better physical function (p = 0.045). In the post-adjuvant phase, SP patients reported less anxiety (p = 0.039). SP patients had higher means in their overall QOL score compared to EP patients across all four phases, and the difference was statistically significant in the immediate postoperative phase (p = 0.033).

Conclusions: Our data indicated that SP patients reported better overall QOL scores across all phases compared to EP patients within our cohort. This study also elucidates opportunities for improving outcomes by proactively addressing chewing and mastication with the assistance of speech pathologists throughout the first 2 years after surgery.