Humans ; Neck Dissection ; methods ; Tongue Neoplasms ; surgery

Carcinoma of the tongue remain one of the greatest management challenges for the head and neck surgeon because of the adverse effects of treatment on oral and pharyngeal function. In early carcinoma of the base of tongue however, the prognosis is encouraging and function of swallowing and speech is preserved despite surgery. Suprahyoid pharyngotomy is one of the surgical approaches advocated for resection of base of tongue tumours with primary anastomosis.
Carcinoma/*surgery ; Hyoid Bone/surgery ; Tongue Neoplasms/*surgery

The annual incidence of oral cancer in the world is more than 300 000, and the five-year survival rate is 50%~60%. Every year, 145 400 people died due to tongue cancer, of which tongue cancer accounts for nearly 40%. Although tongue cancer has tumor heterogeneity and individual differences in prognosis, surgery is still the first choice for the treatment of tongue cancer. The effect of tongue cancer surgery can directly determine the survival time of patients. The defect caused by tongue cancer surgery seriously affects the patients' physical functions such as appearance, language, chewing and swallowing. The surgical treatment of tongue cancer with functional reconstruction can improve the quality of life of patients. In the past few decades, genomics has enhanced understanding of tongue cancer. The preclinical tumor model preserves the tumor heterogeneity, which has a great application prospect in the discovery of tumor biomarkers and the clinical translation of drugs. Many advances have been made in the diagnosis and treatment of tongue cancer, but there are still many controversies in clinical practice. Therefore, this expert consensus summarizes the progress and controversial hot spots of surgical diagnosis and treatment of tongue cancer, mainly including preoperative diagnosis and evaluation, surgical treatment points and postoperative functional rehabilitation.
Carcinoma, Squamous Cell/surgery* ; Consensus ; Humans ; Quality of Life ; Plastic Surgery Procedures/methods* ; Tongue/surgery* ; Tongue Neoplasms/surgery*

OBJECTIVETo compare the thin anterolateral flap with forearm flap in tongue defect repairing, and to introduce our methods and experiences in the tongue reconstruction with the thin anterolateral flap.

METHODSThe clinicopathologic data of 46 cases with tongue carcinoma were obtained from School of Stomatology, Nanjing University Medical Center, Nanjing University from December 2009 to December 2011. To compare two methods of incidence of vascular crisis, tongue shape, language and swallowing functional recovery.

RESULTS46 patients with tongue carcinoma were performed the tongue reconstruction in 12 month, which 12 cases were used the thin anterolateral flap and 34 cases were used the forearm flap. In the thin anterolateral flap group, All cases were succeeded. 1 case occurs vascular crisis. In the forearm flap group, 33 cases were succeeded, and 1 case occurs necrosis. 3 cases occurs vascular crisis. The results of comparing two methods showed that: no obvious differences in the tongue shape, and no obvious differences in the function of language and swallowing.

CONCLUSIONSThere no obvious differences in the reconstruction of tongue defect between the thin anterolateral flap and the forearm flap. The thin anterolateral flap have some advantages: little influence is on the donor site, the flap extent is abundant, the donor site is not spectacular. The thin anterolateral flap should be piror method for the tongue defect repairing.

Aged ; Female ; Forearm ; surgery ; Humans ; Male ; Middle Aged ; Surgical Flaps ; Tongue ; surgery ; Tongue Neoplasms ; surgery ; Treatment Outcome

OBJECTIVETo explore the possibility of tongue reconstruction following cancer resection by a rectus abdominis musculoperitoneal composite flap.

METHODSHalf tongue defect was reconstructed using the rectus abdominis musculoperitoneal composite free flap in 2 patients.

RESULTSThe postoperative period was uneventful and complete survival of the flap was occurred in the 2 cases. The reconstructed tongue showed excellent color match and natural shape.

CONCLUSIONSThe rectus abdominis musculoperitoneal composite flap can be used for tongue defect reconstruction, especially when the defect was not more than half of the tongue.

Abdomen ; surgery ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Tongue ; surgery ; Tongue Neoplasms ; surgery

OBJECTIVETo investigate the application of free anterolateral thigh myocutaneous flap in the reconstruction of tongue and mouth floor defect after radical resection of tongue carcinoma.

METHODSFrom June 2006 to April 2009, 14 cases with tongue carcinoma underwent radical resection, leaving tongue and mouth floor defects which were reconstructed by anterolateral thigh myocutaneous flaps at the same stage. These 14 cases included tongue carcinoma at lingual margin (n=9), at ventral tongue (n=3) and at mouth floor (n=2). The flap size ranged from 7 cm x 9 cm to 5 cm x 7 cm.

RESULTSAll the 14 flaps survived completely with primary healing. There was no functional morbidity in the lower extremities. The patients were followed up for 12-26 months with satisfied esthetic and functional results in reconstructed tongue. Only one case (T4 N1 M0) died of metastasis carcinoma 14 months after operation. No local recurrence happened.

CONCLUSIONSThe anterolateral thigh myocutaneous flap has abundant tissue volume to reconstruct the tongue and mouth floor defect, while leaving less morbidity at donor site. Both satisfied esthetic and functional results can be achieved.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Mouth Floor ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Thigh ; surgery ; Tongue ; surgery ; Tongue Neoplasms ; surgery

OBJECTIVETo evaluate the efficacy of the approach of parasymphyseal mandible osteotomy combined with set-back tongue flap in treatment of tongue base carcinoma.

METHODSIn total 18 patients with cancer of tongue base, 13 were males and 5 females aged of 30 to 65 y (average 52.9 y). Eighteen patients were treated by parasymphyseal mandible osteotomy combined with set-back tongue flap in our hospital from June 2001 to June 2006.

RESULTThe range of follow-up period was 2 to 5 years. All patients had satisfactory speech, swallowing and taste function.

CONCLUSIONParasymphyseal mandible osteotomy provides good exposure, and set-back tongue flap to reconstruction of the base of tongue can partially restore the function of tongue.

Adult ; Aged ; Carcinoma, Squamous Cell ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Mandible ; surgery ; Middle Aged ; Osteotomy ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; Tongue ; surgery ; Tongue Neoplasms ; surgery

OBJECTIVES: Occult cervical lymph node metastasis is the most important reason for recurrence of early-stage tongue cancer and oropharyngeal cancer. Cervical sentinel lymph node (SLN) biopsy may help to identify them. Pigment dyes and radionuclide were used to label SLN. Both of them had shortage. This study aims to investigate the application and clinical value of indocyanine green fluorescence imaging in cervical SLN biopsy for patients with early-stage tongue cancer and oropharyngeal cancer. METHODS: Retrospective analysis was conducted on 23 patients with early tongue cancer and oropharyngeal cancer, who received surgical treatment and used indocyanine green as a tracer to find SLN in Hunan Cancer Hospital from April to October 2021. The detection rate of SLN was calculated and the distribution of SLN in different regions of the neck was analyzed. RESULTS: SLN was successfully identified in 22 of 23 patients, with a detection rate of 95.65%. Among these 22 patients, 3 patients were found to have cancer metastasis, and the rate of occult lymph node metastasis was 13.63%. No pathologically positive lymph nodes were detected in SLN-negative patients, and thus the positive predictive rate was 100%. For patients with primary lesions located in the anterior 2/3 of the tongue, the constituent ratios of SLN in neck area I, II, III, and IV were 15.15%, 71.72%, 13.13%, and 0, respectively. For patients with primary lesions located in base of the tongue, the constituent ratios of SLN in neck area I, II, III, and IV were 0, 44.44%, 44.44%, and 11.12%, respectively. CONCLUSIONS Indocyanine green fluorescence imaging has a high detection rate with accurate positive prediction in the anterior cervical SLN biopsy in patients with early-stage tongue cancer and oropharyngeal cancer. Meanwhile, it can also reflect the lymphatic drainage of tumors located at different primary sites, which has high clinical value.
Humans ; Sentinel Lymph Node Biopsy/methods* ; Indocyanine Green ; Lymphatic Metastasis/pathology* ; Tongue Neoplasms/surgery* ; Retrospective Studies ; Lymph Nodes/pathology* ; Oropharyngeal Neoplasms/surgery* ; Tongue

OBJECTIVETo evaluate head and neck cancer and surgical treatment impact the quality of life (QOL).

METHODSIn this study, 49 cases of head and neck cancer patients were recruited. Among them, 27 cases were laryngeal cancer, 14 cases were tongue cancer and 8 patients were recurrence of nasal pharyngeal cancer after radical radiotherapy. To demonstrate the cancer in different sites of the head and neck impact QOL of the patients in a different way and cancer impact QOL on the physical well-being, social family well-being, emotional well-being, functional well-being of the patients and quality of life (QOL) changed in different time-point before and after operation, QOL was assessed before surgical treatment and at 1,6 months after operation by means of a performance status scale for head and neck cancer patients (PSS-HN) and the functional assessment of cancer therapy head and neck (FACT-H&N) questionnaire.

RESULTSQOL deteriorated significantly in head and neck cancer patients. Cancer in different sites impact on QOL differently especially in patients with tongue cancer (PSS-HN P = 0.0361, FACT-H&N P = 0.0487). Head and neck cancer impact QOL on the physical well-being, social family well-being, emotional well-being, functional well-being of the patients in FACT-H&N questionnaire especially for emotional well-being domains (F = 2.78, P = 0.0311). The QOL in patients deteriorated by surgical treatment and it could be improved following the time. At the 6 months after operation it nearly reached the same scores that assessed before the operation (PSS-HN t = 2.03, P = 0.1120 FACT-H&N t = 1.03, P = 0.1180). Different surgical approaches and different reconstruction methods have different impact on QOL for patients. Laryngeal cancer patients with partial laryngectomy were 107.20 in FACT-H&N while total laryngectomees were 97. 71 at the 6 months after operation, with statistically difference (t = 3.02, P = 0.0430). Tongue cancer patients without reconstruction were 119. 24 in FACT-H&N while the others with reconstruction were 111.39 at the 6 months after operation (t = 3.00, P = 0.0472).

CONCLUSIONSThe QOL in head and neck cancer patients can be assessed by the questionnaire and it can be improved by selecting treatment regimen, surgical approaches and reconstructive methods.

Adult ; Aged ; Female ; Head and Neck Neoplasms ; surgery ; Humans ; Laryngeal Neoplasms ; surgery ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; surgery ; Quality of Life ; Surveys and Questionnaires ; Tongue Neoplasms ; surgery

OBJECTIVETo investigate the outcome of surgical reconstruction of the tongue after hemiglossectomy with reinnervated rectus abdominis musculoperitoneal flaps in the treatment of tongue cancer.

METHODSFive patients underwent immediate reconstruction of the tongue and oral floor defects with rectus abdominis musculoperitoneal flaps after resection of squamous cell carcinoma of tongue. The rectus abdominis musculoperitoneal flap consists of the rectus muscle, posterior rectus sheath, peritoneum, the 10 th, 11th, 12th intercostal nerves and the vascular pedicle that includes the deep inferior epigastric artery and veins. During the operation a reinnervated rectus abdominis musculoperitoneal free flap, in which the intercostal nerves were anastomosed to the descending branch of hypoglossal nerve, was grafted to remaining tongue stump.

RESULTSAll patients recovered uneventfully from surgery, with no immediate postoperative complications. All transplanted flaps survived. The peritoneum was replaced by squamous epithelium 8 weeks after surgery. The average follow-up period was 10 months. During the follow-up period the contour of the reconstructed tongues was satisfactory. The patients demonstrated good functional mobility of the reconstructed and remaining tongue. The swallowing and speech function was nearly at normal levels and the patients could ingest a solid or semisolid diet.

CONCLUSIONSReconstruction of the tongue with rectus abdominis musculoperitoneal flaps after hemiglossectomy is a suitable, cosmetically acceptable method. Long-term follow-up is needed for reaching some final conclusions.

Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Peritoneum ; transplantation ; Reconstructive Surgical Procedures ; methods ; Rectus Abdominis ; transplantation ; Surgical Flaps ; Tongue ; surgery ; Tongue Neoplasms ; surgery ; Treatment Outcome