Objective: To investigate the efficacy of anterolateral thigh flap preforming tongue in patients with total glossectomy. Methods: A total of 27 patients with tongue cancer who underwent total glossectomy, neck lymph node dissection and anterolateral thigh flap transfer were collected from January 2019 to April 2021 in the Department of Oral and Maxillofacial Surgery at the Second Xiangya Hospital. All patients were males, the age ranged from 35-73 years. The patients were divided into experimental (14 cases) and control (13 cases) groups, based on whether the tongue was reconstructed. The clinical parameters of two groups were analyzed by independent sample t test or Fisher exact probability method. Results: The success rate of free flap was 100%, of the patients, 2 patients had cervical hematoma and 1 patient had wound infection postoperatively. There was no difference in speech (6.69±3.42 vs. 5.50±3.01, t=0.96, P=0.346) or swallowing (χ²=0.46, P=0.793) function between two groups at 1 month after surgery. However, the speech (24.94±7.43 vs. 18.44±6.30, t=2.48, P=0.020) and swallowing (χ²=6.97, P=0.008) functions in experimental group were significantly better than those in control group. No case was lost to follow-up. All patients were extubated after operation, with average time of 7.2 days in the experimental group and 7.7 days in the control group. The overall survival rate was 71.4% in the experimental group and 61.5% in the control group. Conclusion: The use of anterolateral thigh flap preforming tongue can improve the speech and swallowing functions in patients with total glossectomy and offer a novel method for tongue construction.
Male ; Humans ; Adult ; Middle Aged ; Aged ; Female ; Glossectomy ; Thigh ; Tongue ; Tongue Neoplasms ; Free Tissue Flaps

OBJECTIVE: This study aimed to compare the influences of postoperative oral function in patients with median or paramedian mandibulotomy during the radical resection of tongue carcinoma and to provide evidence for the choice of osteotomy location for mandibulotomy. METHODS: The clinical data of 126 patients who underwent combined radical neck dissection with mandibulectomy and glossectomy followed by simultaneous reconstruction were analyzed retrospectively. The patients were divided into two groups according to the position of mandibulotomy: median mandibulotomy group (median group, n=60) and paramedian mandibulotomy group (paramedian group, n=66). The fourth edition of the University of Washington Quality of Life Questionnaire (UW-QOL) was used to compare the differences in oral functions, such as swallowing, mastication, and speech, between the two groups during regular follow-up. SPSS 24.0 software package was used for statistical analysis, and P<0.05 was considered statistically significant. RESULTS: Six months after the operation, no significant differences in swallowing, mastication, and speech functions were found between the median and paramedian groups. However, the swallowing and speech functions in the paramedian group were better than those in the median group 1 year after the operation (P<0.05), whereas no statistical difference in mastication function was observed between the two groups. CONCLUSIONS Evaluation of the postoperative oral function results showed that paramedian mandibulotomy was a better surgical approach than median mandibulotomy. Paramedian mandibulotomy is worth prioritizing in the radical resection of tongue carcinoma.
Glossectomy ; Humans ; Mandibular Osteotomy ; Quality of Life ; Retrospective Studies ; Tongue Neoplasms

OBJECTIVE: To evaluate the swallowing problems after a primary resection in patients with tongue cancer. METHODS: Thirty-eight patients with primary tongue cancer, who underwent a glossectomy and had undergone a Video Fluoroscopic Swallowing Study (VFSS) prior to surgery in a university hospital between January 2010 and May 2015, were included retrospectively. The clinical and swallowing features, including the VFSS parameters before and after surgery, were analyzed. RESULTS: Among the 38 patients, 33 patients were T1 and T2 stage. Thirty-one, six and one patient underwent a partial glossectomy, hemiglossectomy, and total glossectomy, respectively. More than ninety percent of the patients had a selective neck dissection. All the patients were on a regular diet before surgery and showed no penetration or aspiration on the VFSS. Immediately after surgery, 33 patients (87%) had to change to non-oral feeding. At discharge, 8 patients (21%) maintained non-oral feeding, and 30 patients ate a limited diet. In a telephone survey (mean 19 months after surgery), among the 25 survey participants, 24 patients (96%) reported no problems with their regular diet. CONCLUSION: In tongue cancer patients with low Tumor-Node-Metastasis (TNM), American Joint Committee on Cancer (AJCC) stages, a primary resection of tongue cancer did not cause statistically significant dysphagia after surgery. Although many patients had to change their diet to limited or non-oral feeding immediately after surgery, almost all patients improved and could eat a regular diet after the long term follow up.
Deglutition ; Deglutition Disorders* ; Diet ; Follow-Up Studies ; Glossectomy ; Head and Neck Neoplasms ; Humans ; Joints ; Neck Dissection ; Retrospective Studies ; Telephone ; Tongue Neoplasms* ; Tongue*

For the success of complete denture, three essential requirements such as retention, stability and support are needed. Moreover, due to the absorption of residual ridge and scarring due to the surgery, when making a complete denture, which is difficult to form the mandibular lingual margins, various considerations such as the arrangement of the Non-anatomical dl non-anatomical teeth, the polished surface impression, the internally weighted metal framework and the use of the denture adhesive cream are necessary. In this case report, the patient has a severely resorbed edentulous ridge from severe periodontitis and has some soft tissue problems after the glossectomy due to tongue cancer. To obtain additional retention and stability, some trials such as polished surface impression taking, internally weighted metal insertion and minimal pressure impression were done for the better result. Moreover To make a metal framework that precisely shapes the desired three-dimensional shape and reduces the complicated process, minimal pressure impression method and direct metal laser sintering technique were used.
Absorption ; Adhesives ; Cicatrix ; Denture, Complete ; Dentures ; Glossectomy ; Humans ; Methods ; Periodontitis ; Tongue Neoplasms ; Tooth

Macroglossia is a rare clinical condition defined as an enlarged tongue. Macroglossia can cause structural deformities like diastema and disproportionate mandibular growth and present functional disorders such as dysarthria, dysphonia, and respiratory problems. A 7-year-old boy who had lymphangiomatous macroglossia was treated with a reduction glossectomy by anchor-shaped combination of a U-shape and modified key-hole resection. Postoperatively, the reduced tongue was contained completely within the oral cavity, but open bite remained due to prognathism. Sensory and motor nerves to the tongue appeared to be intact, and circulation was adequate. This patient will be monitored for recurrence of tongue enlargement.
Child ; Congenital Abnormalities ; Diastema ; Dysarthria ; Dysphonia ; Glossectomy ; Humans ; Lymphangioma ; Macroglossia ; Male ; Mouth ; Open Bite ; Prognathism ; Recurrence ; Tongue

BACKGROUND: Although previous studies have focused on determining prognostic and causative variables associated with fistula-related complications after head and neck reconstructive surgery, only a few studies have addressed preventive measures. Noting that pooled saliva complicates wound healing and precipitates fistula-related complications, we devised a continuous suction system to remove saliva during early postoperative recovery. METHODS: A continuous suction system was implemented in 20 patients after head and neck reconstructive surgery between January 2012 and October 2017. This group was compared to a control group of 16 patients at the same institution. The system was placed orally when the lesion was on the anterior side of the retromolar trigone area, and when glossectomy or resection of the mouth floor was performed. When the orohypopharynx and/or larynx were eradicated, the irrigation system was placed in the pharyngeal area. RESULTS: The mean follow-up period was 9.2±2.4 months. The Hemovac system was applied for an average of 7.5 days. On average, 6.5 days were needed for the net drain output to fall below 10 mL. Complications were analyzed according to their causes and rates. A fistula occurred in two cases in the suction group. Compared to the control group, a significant difference was noted in the surgical site infection rate (P < 0.031). CONCLUSIONS: Clinical observations showed reduced saliva pooling and a reduction in the infection rate. This resulted in improved wound healing through the application of a continuous suction system.
Fistula ; Follow-Up Studies ; Glossectomy ; Head* ; Humans ; Larynx ; Mouth Floor ; Neck* ; Saliva ; Suction* ; Surgical Wound Infection ; Wound Healing

The tongue, especially its lateral part, is the most common site of oral tumors. Patients who undergo glossectomy for the treatment of tongue cancer may experience difficulty in proper functioning for pronunciation, chewing, swallowing, and oral hygiene maintenance; therefore, a palatal augmentation prosthesis can be used to restore function of the tongue. In this case, an implant overdenture was used in a patient who had residual ridge resorption and obliteration of alveololingual sulcus after undergoing glossectomy for tongue cancer treatment. In addition, a palatal augmentation prosthesis with a metal framework, support, and retention part was fabricated. The palatal vault was reduced, so that even with limited tongue movement, adequate tongue-palate contact could be achieved. After placement of the definitive prostheses, the patient showed improvement in the functions of chewing, swallowing, and pronunciation.
Deglutition ; Denture, Overlay* ; Glossectomy ; Humans ; Mastication ; Oral Hygiene ; Prostheses and Implants* ; Rehabilitation* ; Tongue Neoplasms* ; Tongue*

If complication arises after glossectomy which leads to trouble in forming food bolus or transfer of the food, it is possible that either food bolus may block the airway or dysphagia may occur as the food bolus goes down into the airway. To solve the issue, palatal augmentation prosthesis could be used. In this case, the patient with an oral cancer is having difficulties swallowing food after glossectomy. Through taking impressions of polishing surface of his denture referring his tongue movement, the complete denture for the upper jaw was created using the concept of palatal augmentation prosthesis. This new upper denture increases the palatal-tongue contact pressure, allowing the patient to perform better swallowing and better pronunciation.
Deglutition ; Deglutition Disorders ; Denture, Complete ; Dentures ; Glossectomy ; Humans ; Jaw ; Mouth Neoplasms ; Prostheses and Implants ; Tongue

OBJECTIVES: The purpose of this study was to evaluate and compare the treatment outcomes of partial glossectomy with or without elective neck dissection in patients with tongue squamous cell carcinoma (SCCa). MATERIALS AND METHODS: A total of 98 patients who were diagnosed with tongue SCCa and underwent partial glossectomy between 2005 and 2014 were evaluated. Only 14 patients received elective neck dissection, and 84 patients received only partial glossectomy. RESULTS: There were 56 men and 42 women with a mean age of 57 years and mean follow-up period of 33.7 months. There were 70 patients graded as T1 and 28 as T2. The total occult metastasis rate was 17.3%. The 5-year overall survival rate was 83.3% with elective neck dissection and 92.4% with observation. The 5-year disease-free survival rate was in 70.7% in the elective neck dissection group and 65.3% in the observation group. CONCLUSION: We retrospectively reviewed the records of 98 patients with tongue SCCa. These patients were divided into two groups, those who underwent elective neck dissection and those who did not. There was no statistically significant difference between the groups undergoing partial glossectomy with or without elective neck dissection.
Carcinoma, Squamous Cell* ; Disease-Free Survival ; Epithelial Cells* ; Female ; Follow-Up Studies ; Glossectomy ; Humans ; Male ; Neck Dissection* ; Neck* ; Neoplasm Metastasis ; Retrospective Studies ; Survival Rate ; Tongue*

BACKGROUND AND OBJECTIVES: The adequate safety margin in tongue cancer is the most important prognostic factor for local recurrence and survival. This study aimed to evaluate the resection margins using a new technique of tongue resection under the guidance of guide wire under ultrasonography in patients with tongue cancer. SUBJECTS AND METHOD: In this prospective study, 10 patients with presurgical, biopsy-proven, clinical T1 or T2 tongue squamous cell carcinomas underwent resection under the guidance of guide wire inserted using ultrasonography. The data of resection margins of 37 patients who underwent partial glossectomy using the conventional method of palpation were used as control data. RESULTS: The mean safety margins (mm) of the experimental group were 7.59±4.30 (anterior), 8.56±4.69 (posterior), 5.25±3.01 (superior), 5.93±3.66 (inferior), 13.00±13.29 (medial), 5.78±2.64 (deep), and 6.67±3.06 (lateral). There were no differences in the safety margins between the two groups. CONCLUSION: Using guide wire under ultrasonography was not superior to the conventional method for partial glossectomy for having adequate resection margins.
Carcinoma, Squamous Cell ; Glossectomy ; Humans ; Methods ; Palpation ; Prospective Studies ; Recurrence ; Tongue Neoplasms* ; Tongue* ; Ultrasonography*