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 clinical applicability and outcomes of the combined radical operation without breaking the lower lip and mandible with one-stage reconstruction using free anterolateral thigh flap for tongue and lingual root carcinoma.

METHODSThe operation with or without breaking lower lip and mandible was performed respectively in 245 patients (experimental group) and 120 patients (control group).

RESULTSRemoval of tumor and neck dissection were conducted successfully in all patients of two groups with no serious postoperative complication. With the follows-up of 6 to 36 months, in the patients of experimental group there was no recurrence for primary sites but 3 cases with neck lymphnode recurrence, the functions of chewing, swallowing and speaking were good, there was no damage to appearance, and no osteoradionecrosis occurred in the lymphnode positive cases after radiotherapy; in the patients of experimental group there was no recurrence for primary sites but 4 cases with neck lymphnode recurrence, the functions of chewing, swallowing and speaking were good, but there was apparent scar in neck and face, and osteoradionecrosis occurred in 11 of lymphnode positive cases.

CONCLUSIONSThe combined radical operation without breaking the lower lip and mandible with one-stage reconstruction using free anterolateral thigh flap is feasible for tongue and lingual root carcinoma (T2-T3), which reduces the risk for osteoradionecrosis in lymphnode positive cases after radiotherapy and keeps good appearance for patients.

Carcinoma ; surgery ; Free Tissue Flaps ; Humans ; Lingual Nerve ; pathology ; surgery ; Lip ; surgery ; Mandible ; surgery ; Neck Dissection ; Osteoradionecrosis ; Postoperative Complications ; Thigh ; Tongue ; surgery ; Tongue Neoplasms ; pathology ; surgery

OBJECTIVETo evaluate the efficacy of pedicled supraclavicular artery island flaps for head and neck reconstruction.

METHODSReconstructive surgeries for head and neck oncologic defects were performed with the pedicled supraclavicular artery island flaps in 10 patients from May 2013 to December 2014 and the cases were review. Among them, 6 were performed for hypopharyngeal cancer, 2 for oral tongue cancer, 1 for oral base cancer and 1 for cervical esophageal cancer. The size of the flaps was measured in (5-8) cm × (6-12) cm.

RESULTSSeven flaps survived, one flap failured and two flaps had partial necrosis. Donor sites were closed primarily without morbidity.

CONCLUSIONThe pedicled supraclavicular artery island flap is an easy harvesting and reliable for head and neck reconstruction, especially suitable for otolaryngo-head and neck surgeon and maxillofacial surgeon in the local hospital.

Arteries ; Esophageal Neoplasms ; surgery ; Head ; surgery ; Head and Neck Neoplasms ; surgery ; Humans ; Mouth Neoplasms ; surgery ; Neck ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps ; Tongue Neoplasms ; surgery ; Treatment Outcome

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

OBJECTIVETo investigate the value of microsurgical reconstruction of the tongue after hemiglossectomy with lateral arm free flaps in the treatment of tongue cancer.

METHODSFrom October 2006 to April 2007, ten patients underwent simultaneous reconstruction of the tongue and oral floor defects with lateral arm free flaps after resection of squamous cell carcinoma of tongue in our hospital. The flaps ranged from 8 cm x 5 cm to 9 cm x 6 cm in size, and were adjusted to the defect of the tongue. The vascular pedicle included the posterior radial collateral artery and the accompanying veins. The outcome of reconstruction was evaluated by follow-up examinations, including the contour and mobility of the reconstructed tongue, the swallowing function and the speech function.

RESULTSAll patients recovered uneventfully from surgery, without any major postoperative complications. The transplanted flaps survived. During follow-up period the contour of the reconstructed tongues was satisfactory. The patients demonstrated good functional mobility of the reconstructed and remaining tongue. Postoperatively, the swallowing and speech function was nearly at normal levels and the patients could ingest a solid or semisolid diet.

CONCLUSIONSMicrovascular reconstruction of the tongue with lateral arm free flaps after hemiglossectomy is an ideal and safe method, but long term results need to be further studied.

Adult ; Arm ; Carcinoma, Squamous Cell ; surgery ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps ; blood supply ; Tongue ; surgery ; Tongue Neoplasms ; surgery ; Treatment Outcome