Long‐term subjective tongue function after partial glossectomy

Lee, D. Y.; Ryu, Young Jin; Hah, J. Hun; Kwon, Taekyoung; Sung, Myung‐Whun; Kim, Kyae Hyung

doi:10.1111/joor.12193

Cited by 26 publications

(15 citation statements)

References 13 publications

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“…They found a significantly better functional outcome for the non-reconstructed patients. These results are in line with data published from some other centers investigating the role of oral and oropharyngeal reconstruction [15,16]. When the resection is larger the literature is more supportive towards reconstruction.…”

Section: Discussionsupporting

confidence: 90%

A descriptive study highlighting the differences in the treatment protocol for oral tongue cancer in Sweden and Finland

Mäkitie

Kamali

Mroueh

et al. 2019

Acta Oto-Laryngologica

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Background and Aims: Stage II cancer of the tongue is mostly managed surgically both locally and regionally. However, indications for postoperative radiotherapy and reconstructive options vary between centers. This paper aims to describe differences in treatment in a geographically homogenous cohort. Methods: A retrospective comparison was made between two cohorts of clinical T2N0 tongue cancer from Finland and Sweden. The Finnish cohort included 75 patients and the Swedish 54. All patients had curative intent of treatment and no previous head and neck cancer. Data analyzed consisted of pathological stage, size and thickness of tumor, frequency of reconstruction, radiotherapy delivered, and survival. Results: The Finnish cohort included a higher proportion of patients managed with reconstructive surgery (67%) than the Swedish cohort (0%), p<0.00001. More patients were treated with postoperative radiotherapy (84%) in the Swedish cohort than in the Finnish (54%), p<0,0002. The Finnish cohort had a higher level of survival and included more frequent downstaging (cTNM to pTNM). Conclusions and significance: Our data indicate a major difference in the management of T2N0 oral tongue cancer. The optimal cutoff size and growth pattern of the tumor warranting reconstruction should be further evaluated in a prospective manner considering both survival and quality of life.

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Section: Discussionsupporting

confidence: 90%

A descriptive study highlighting the differences in the treatment protocol for oral tongue cancer in Sweden and Finland

Mäkitie

Kamali

Mroueh

et al. 2019

Acta Oto-Laryngologica

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“…However, while the variation in asymmetry increases with T-stage and type of treatment, the median does not, which is largely in line with the rest of the results. The same can be found in other literature such as Zuydam et al[8] where speech scores after surgery are overlapping between T-stages or did not yield significant correlation with speech function[8,10]. Furthermore, it is shown in previous literature that post-operative impairment not only depends on the size and location of the treatment but also on the amount of scar tissue and compensatory tongue motion patterns[12,14].…”

Section: Discussionsupporting

confidence: 75%

“…Surgical treatment of lateral tongue carcinoma often leads to asymmetrical tongue movements[6,7]. With increasing T stage this impairment becomes more outspoken and is accompanied by deterioration of speech quality and mastication function[8–10]. The organ sparing surgical chemoradiation is usually the preferred treatment for base of the tongue tumors, but in advanced cases this modality may also lead to serious functional deficits with more impact on swallowing than surgery of the mobile tongue[3,11].…”

Section: Introductionmentioning

confidence: 99%

Quantification of tongue mobility impairment using optical tracking in patients after receiving primary surgery or chemoradiation

et al. 2019

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Purpose Tongue mobility has shown to be a clinically interesting parameter on functional results after tongue cancer treatment which can be objectified by measuring the Range Of Motion (ROM). Reliable measurements of ROM would enable us to quantify the severity of functional impairments and use these for shared decision making in treatment choices, rehabilitation of speech and swallowing disturbances after treatment. Method Nineteen healthy participants, eighteen post-chemotherapy patients and seventeen post-surgery patients were asked to perform standardized tongue maneuvers in front of a 3D camera system, which were subsequently tracked and corrected for head and jaw motion. Indicators, such as the left-right tongue range and the deflection angle with the horizontal axis were extracted from the tongue trajectory to serve as a quantitative measure for the impaired tongue mobility. Results The range and deflection angle showed an excellent intra- and interrater reliability (ICC 0.9) The repeatability experiment showed an average standard deviation of 2.5 mm to 3.5 mm for every movement, except the upward movement. The post-surgery patient group showed a smaller tongue range and higher deflection angle overall than the healthy participants. Post-chemoradiation patients showed less difference in tongue ROM compared with healthy participants. Only a few patients showed asymmetrical movement after treatment, which could not always be explained by T-stage or the side of treatment alone. Conclusion We introduced a reliable and reproducible method for measuring the ROM and to quantify for motion impairments, that was able to show differences in tongue ROM between healthy subjects and patients after chemoradiation or surgery. Future research should focus on measuring patients with oral cancer pre- and post-treatment in combination with the collection of detailed information about the individual tongue anatomy, so that the full ROM trajectory can be used to identify changes over time and to quantify functional impairment.

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“…Regarding tongue reconstruction after partial glossectomy, previous studies have reported only functional outcomes of one reconstructive method and con icting results about the optimal reconstructive method. A long-term follow-up study of 63 patients with partial glossectomy of the tongue appeared good speech and swallowing function without ap reconstruction [17]. A prospective multicenter study also reported that the postoperative speech and swallowing function were better following a primary closure compared to a free ap reconstruction for a partial glossectomy [18].…”

Section: Discussionmentioning

confidence: 97%

The comparison of the functional outcomes between primary closure and reconstruction with free flap after resection of T1 stage tongue cancer: A prospective study

Pathak

Yang

et al. 2020

Preprint

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Abstract Background: Reconstruction with free flap after the resection of tongue cancer is commonly used by craniofacial surgeons. However, it is unknown whether the reconstruction with free flap is better than the primary closure for the T1 stage tongue cancer. The objective of this prospective study is to compare the functional outcomes between these two methods.Methods: In this prospective study, 30 patients who were diagnosed as T1 stage tongue cancer (on anterior -two third of the tongue) were randomly divided into two groups. The first group underwent the primary closure after the resection (15 patients) and the second group were reconstructed with the anterolateral perforator flap (15 patients). All patients underwent postoperative functional evaluation using specific questionnaires and a screening test with special emphasis on speech, swallowing, and tongue mobility at 1, 3, 6 and 12 months.Results: Functional outcomes, including tongue mobility, speech, and swallowing, were all better in primary closure than anterolateral thigh flap group. At 1-month post-op, the speech understandability of the patients who received a primary closure were statistically better than those who received ALT flap (p = 0.01), while at 1-year post-op, there was no significantly different on speech understandability between two groups (p = 0.16). Statistically significant differences were found between the two groups in the swallowing capacity at all four different time periods (p < 0.05). For the primary closure group, tongue mobility was statistically better at all four different time periods than in ALT flap group (p < 0.05).Conclusion: For the tongue cancer patients (T1), reconstruction with primary closure, rather than with flap, can reserve more functions including tongue mobility, speech and swallowing outcomes, and therefore might be the appropriate reconstruction method after partial glossectomy.

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Long‐term subjective tongue function after partial glossectomy

Cited by 26 publications

References 13 publications

A descriptive study highlighting the differences in the treatment protocol for oral tongue cancer in Sweden and Finland

A descriptive study highlighting the differences in the treatment protocol for oral tongue cancer in Sweden and Finland

Quantification of tongue mobility impairment using optical tracking in patients after receiving primary surgery or chemoradiation

The comparison of the functional outcomes between primary closure and reconstruction with free flap after resection of T1 stage tongue cancer: A prospective study

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