From October 1999 to July 2005, defects after total glossectomy with laryngectomy (TGL) for cancer of the tongue or middle pharynx were reconstructed with rectus abdominis myocutaneous (RAMC) flaps in nine patients. Total glossectomy with laryngeal preservation is considered a feasible option, despite its morbidity. tissue defects of total or near-total glossectomy.Methods. Background Oral tumor resections cause articulation deficiencies, depending on the site, extent of resection, type of reconstruction, and tongue stump mobility.. Perceptual analyses involved . Even large regional flaps, however, such as a pectoralis flap or a pedicled latissimus flap, may not be useful for total glossectomy defect reconstruction if the donor flap lacks sufficient tissue bulk. Following total glossectomy, besides articulation, both oral and pharyngeal phases of swallowing are grossly affected, and with the absence of laryngeal elevation during swallowing, patients are at increased risk of aspiration. Glossectomy via transcervical pull-through is a technique that releases the tongue into the neck through the floor of the mouth by opening the sublingual and submental compartments. Despite high reconstructive success rates, the likelihood of locoregional and distance recurrence was high. Plastic and Reconstructive Surgery, Vol. A . While there are many classifications, glossectomy is commonly classified by the laterality (left, right, or midline) and the proportion of tongue removed. This refers to removal of part of the tongue (partial glossectomy), half of the tongue. Contemporary Transoral Surgery For Primary Head And Neck ... and larynx. During this procedure, the doctor will remove a large part of your tongue, and perform reconstruction surgery to repair the wound so that you can swallow and speak as well. Sharma M, Iyer S, Kuriakose MA, Vijayaraghavan S, Arun P, Sudhir VR, Chatni SS, Sharan R. Functional reconstruction of near total glossectomy defects using composite gastro omental-dynamic gracilis flaps. A total glossectomy will require a major reconstructive surgery. Amunk. Total or subtotal glossectomy with microsurgical ... For this reason we developed a new flap design to compensate for insufficient flap volume in thin patients. Indications, reconstructive techniques, and results for ... Because if you had a Total glissectomy, or a Subtotal like myself-- it's doubtful you would be Able to Eat many different foods. Background Few studies on tongue reconstruction provide a comprehensive, multidisciplinary analysis examining defect size, flap selection, function, and long-term survival. Total glossectomy—resection including the oral and base of tongue—remains the most significant surgical alternative for patients with advanced cancers of the tongue, but given the current advancements in reconstruction and rehabilitation, patients can return to oral alimentation, near-normal activities, and an acceptable quality of life. Associated procedures might include a tracheotomy, feeding tube placement, neck dissection, floor of mouth resection or mandibulectomy. Following total glossectomy, right oropharyngectomy, and total laryngectomy for T4a squamous cell carcinoma (SCC) of the right oral tongue, the FF was harvested and set on the operating room back table (A) with the elongated vascular pedicle (arrowhead), skin (block arrow), and latissimus (arrow). Glossectomy is a term used to describe a family of surgical procedures resulting in resection of the tongue. Speech samples were collected on three occasions within the first 3 months following glossectomy. major resection, particularly in cases of recurrence or sal- The myocutaneous RAFF is one of the main options vage surgery, in which obtaining free margins is a limit- for reconstruction after total glossectomy. cancer before and after subtotal glossectomy and reconstruction with a rectus abdominis musculocutaneous flap. Buccinator Myomucosal Flap for Reconstruction of ... N2 - The vertical rectus abdominus myocutaneous (VRAM) flap is a valuable option for tongue reconstruction. Total glossectomy Complete the bilateral neck dissections before resecting the primary tumour (Figure 13). DIEAP Flap for Total Glossectomy Reconstruction. This technique does not require the addi- This aims to reliably close the wound and keep the tongue moving freely during speech and swallowing. Rectus Abdominis free flap. Peirong Yu, in Head and Neck Reconstruction, 2009. Scott Carlisle's improvement in speech over time after his total glossectomy. DOI: 10.1177/0194599813487492 Corpus ID: 7231996. Patient The patient was a 41-year-old man with a diagnosis of squamous cell carcinoma of the tongue on the left side (T 4N 0M 0). For example, the ideal shape to reconstruct a hemiglossectomy defect is a triangle, as we have shown that the 2D defect with this resection is a right triangle. Total glossectomy via transcervical approach and reconstruction. o a total glossectomy is removal of the entire tongue, . Objective: The total oral tongue (anterior 2/3 glossectomy) defect is seldom addressed in the literature. These complex defects require reconstruction with moderate to large volume flaps to restore the bulk of the tongue. There are several methods of reconstruction following a total laryngopharyngectomy, including a regional flap, a gastric pull-up, or a free flap. He is able to communicate via writing. Speech and Swallowing Data in Individual Patients Who ... Swallow dysfunction is a significant morbidity following glossectomy in the treatment of oral cavity tongue carcinoma. Glossectomy. Beavertail modification of the radial forearm free flap in ... 2019; 129(5):1087-1092 (ISSN: 1531-4995) Han AY; Kuan EC; Mallen-St Clair J; Badran KW; Palma Diaz MF; Blackwell KE; St John MA Total Glossectomy - YouTube Total glossectomy with laryngeal preservation and free flap reconstruction: Objective functional outcomes and systematic review of the literature. 2, pp. A patient admitted POD#8 s/p total laryngectomy, total glossectomy with flap reconstruction, left partial pharyngectomy. The flap was harvested from the left chest and used for reconstruction. The patient underwent subtotal glos- Tongue cancer is uncommon, and it's especially unusual for it to strike a young person who doesn't smoke or drink heavily. Although several options of reconstruction exist, reconstruction with PMMC allows recovery of swallowing function in majority of the patients. The tongue's jobs include tasting, swallowing, breathing, licking and speaking. Plast Reconstr Surg. Various pedicled and free tissue flaps have been advocated, but long-term . Lip and oral cavity cancer treatment (adult). It can be used to treat cancers of the tongue, some oral cavity (inside the mouth) and throat cancers. The deep inferior epigastric artery perforator (DIEAP) flap for total glossectomy reconstruction. 104, Issue. Reconstruction of total or near-total glossectomy defects has been challenging and the functional outcomes are often disappointing. About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features Press Copyright Contact us Creators . This report presents the largest study in the literature evaluating free flap reconstruction after glossectomy. (hemiglossectomy), or all of the tongue (Total glossectomy). • A series of 15 patients undergoing total glossectomy for advanced carcinoma of the tongue was analyzed with regard to operative management, oral reconstruction, rehabilitation of deglutition and speech, and survival. Purpose Presently, the functional reconstruction of the tongue in patients after subtotal or total glossectomy with the removal of the oral floor muscles and spearing of the larynx remains a complicated and unsolved issue. The neck specimen was removed in continuity with the primary tumour using a pull-through approach. Most patients experience numbness or altered sensation to the tongue on the side of the operation. These include partial glossectomy (less than one-half), hemiglossectomy (half of the tongue), subtotal glossectomy (more than half . Surgical techniques Flap design and elevation: the ALT flap 6-8. The treatment of the neck is critical in patients with tongue SCC. A 38-year-old male patient with recurrent squamous cell carcinoma, originating from the left base of the tongue trespassing the midline to the right (a), underwent total glossectomy (b). We carried out 24 total glossectomies and 15 subtotal glossectomies. Conclusions: Total glossectomy for oncologic control is . Total glossectomy: This is the removal of the entire tongue, including the base of the tongue. 89, no. Variables evaluated included wound complications, major and minor morbidity, return to the operating room, mortality, and mean operative time. Plast Reconstr Surg 2014 Aug;134(2):341e-344e. Arch Otolaryngol Head Neck Surg. Functional outcome after total and subtotal glossectomy with free flap reconstruction Functional outcome after total and subtotal glossectomy with free flap reconstruction Yanai, Chie; Kikutani, Takesi; Adachi, Masatosi; Thoren, Hanna; Suzuki, Munekazu; Iizuka, Tateyuki 2008-07-01 00:00:00 Background The aim of this study was to evaluate postoperative oral functions of patients who had . A total glossectomy may be performed along with a total laryngectomy in order to prevent aspiration (breathing food or drink into lungs) and pneumonia. J Oral Maxillofac Surg 2012. After the first 6 month I learnt to eat all foods ( hot dogs, steak, pizza, everything) I use a . o Reconstruction: Some patients may have a large portion of their tongue removed and require reconstruction at the same time. Postoperative complications and functional results after total glossectomy with microvascular reconstruction. Purpose: Swallowing function was in a patient with tongue cancer that was evaluated with video fluorography before and after subtotal glossectomy and reconstruction with a rectus abdominis muscuocutaneous flap. . Total Glossectomy With Free Flap Reconstruction: Twenty-Year Experience at a Tertiary Medical Center. A regional flap consists of tissue from an area near the tumor site that is used to reconstruct the resected area while remaining connected to its regional blood supply.The most common regional flap utilized is a pectoralis major flap. Selecting an ideal flap for reconstruction of total glossectomy defects should be patient specific and based on matching donor flap bulk. For example, in a study by Longo et al., all 13 patients resumed oral feed- Life After Tongue Cancer, & a Total Glossectomy. In all cases, the flap was placed through a midsymphyseal mandibulotomy approach, and adequate positioning and contouring of the flap was achieved . The latissimus is fastened to secure the . However, as reconstruction techniques have evolved, also better functional results have recently been reported in some small series. While patients often underwent elective total laryngectomy to prevent aspiration. The adequacy of regional flaps depends on the size of the tongue defect and the donor site's tissue bulk. Most subtotal glossectomy defects involve the entire mobile tongue and 50% or more of the base of the tongue. CAS Article PubMed Google Scholar 5. Because the muscular action of the tongue is not… In this article, the 10-year experience of total or near-total tongue reconstruction at the University of Texas M.D. Approximately half of patients that undergo glossectomy with MVFTT reconstruction achieve a total oral diet, with most attaining this goal within 30 days. Results. The tongue is about 3.1 to 3.3 inches in size. 65 of 79 questionnaires were returned (82.27%). Quality of life was assessed by means of the University of Washington Quality of Life (UW-QOL) and the 14-item Oral Health Impact Profile (OHIP-14), after 12 months post-operatively. Our flap design for total tongue reconstruction is intended to fit exact recipient-site specifications, without the need for modification once harvested. This treatment approach demonstrates high tracheostomy and gastric tube independence. IMPORTANCE The optimal reconstruction of total glossectomy defects with or without total laryngectomy is controversial. Importance The optimal reconstruction of total glossectomy defects with or without total laryngectomy is controversial. The data on the swallowing and speech outcomes are consistent with the literature. In the past 5 years I never visited any web sites that dealt with oral cancers nor have I gone to any support groups. Total glossectomy was associated with a total laryngectomy in eight patients. 119-122, 2003. Anderson Cancer Center is reviewed. Kate Brown was just 32 years old, recently married and beginning a new job, when she learned that a spot on her tongue was stage III tongue cancer. In one experience, total laryngectomy was the required surgical approach in 10% of T1 and 55% of T2 tumors. López-Arcas JM, Arias J, Morán MJ, Navarro I, Pingarrón L, Chamorro M, Burgueño M. J Oral Maxillofac Surg, 70(3):740-747, 29 Jul 2011 Cited by: 5 articles | PMID: 21802813 A total glossectomy will require a major reconstructive surgery. The aim of the study is to describe the use of the beavertail modified radial forearm free flap (BTRFFF) to reconstruct a total oral tongue defect and the functional and quality of life outcomes associated . Ok, this leads me to ask you again, about your Glossectomy. You say you can Eat many different foods. Postoperative complications and functional results after total glossectomy with microvascular reconstruction 7, p. 2015. View Media Gallery. To reconstruct this extended range of mucosal defect, it is necessary to overcome the remarkable discrepancy of apertures of oral and esophageal sides. A series of 15 patients undergoing total glossectomy for advanced carcinoma of the tongue was analyzed with regard to operative management, oral reconstruction, rehabilitation of deglutition and speech, and survival. Other approaches include transoral laser excision, laryngofissure, and partial laryngectomy. He has a f/u visit in 2 weeks with the surgeon for PO trial. Total glossectomy: This procedure includes removal of the whole tongue. Transcervical approach was performed for tumor resection (c). Total glossectomy reconstruction with anterolateral thigh flap. Reconstruction following total laryngopharyngectomy with total glossectomy (TLPTG) is challenging. The purpose of the present study was to determine the swallowing outcome after oral microvascular free flap reconstruction of oral post-oncologic defects, showing that free flaps can satisfactorily restore the swallow function with only one exception being those patients who suffer from a hemiglossectomy or a total glossectomy. Total or subtotal glossectomy with laryngeal preservation: . López-Arcas et al. Methods: A retrospective analysis of 12 total glossectomies with laryngeal preservation was performed in order to assess the available reconstruction techniques and analyze survival and functional outcomes. There are several different types of glossectomy, including: Partial glossectomy: A partial glossectomy is a procedure done to remove a portion of the tongue. This is often permanent if the tumour was close to the lingual nerve. Patients and Methods 2.1. 2000;106(5):1028-1035. One- and 5-year survival rates were 42% and 26%, with locoregional and distant recurrence reported at 36% and 25%, respectively. Total glossectomy: A total glossectomy is a procedure done to remove the whole tongue and will also require a laryngectomy and reconstructive surgical procedures. Various pedicled and free tissue flaps have been advocated, but long-Term data on functional outcomes are not available to date. Reconstruction surgery for total laryngopharyngectomy and total glossectomy with total esophagectomy was performed using gastric pull up and two pectoralis major flaps. Methods A retrospective review of patients undergoing free flap glossectomy reconstruction from 2000 to 2012 . Total glossectomy for oncologic control is most commonly performed in patients who have stage IV cancers. Urken ML, Moscoso JF, Lawson W, Biller HF. These anatomical and physiological considerations form the basis of functional reconstruction following total glossectomy. . It is made up of two parts: Objectives To evaluate the speech intelligibility of patients undergoing total, subtotal, or partial glossectomy, before and after speech therapy.. A total glossectomy is performed along with a total laryngectomy in order to prevent aspiration and pneumonia. 2. Laryngoscope. a total glossectomy is removal of the entire tongue, including the base of the tongue in the throat. However, thin patients often have too little fat tissue to ensure adequate flap volume. Similarly, a total glossectomy defect would ideally involve the use of a square free flap, and a base of tongue defect would employ a trapezoid-shaped flap for optimal reconstruction. A total of 1,012 glossectomy patients were identified, with 805 undergoing nonflap reconstruction and 207 undergoing free flap reconstruction. There was mention in hospital notes of consult to SLP for electrolarynx, but I'm not sure if he has one at our facility. Optimal reconstruction of TGLP defects may be accomplished with either pedicled or free-tissue flap reconstruction. 7. National Cancer Institute website. 2013;123(1):140-145. Surgical management of the neck. the neo-tongue. It requires mandible reconstruction after ablation is completed. OBJECTIVES To compare various total glossectomy defect reconstructive techniques used by multiple . Voice-sparing surgery is an option in many, but not all, of these cancers. The patient underwent subtotal glossectomy and total resection of the floor of the mouth and the right lateral wall of the oropharynx using the MLRA , along with ipsilateral modified radical neck dissection and tongue reconstruction using a TMF. It is generally accepted that routine surgical dissection of the node-positive neck is required for advanced stage oral cavity SCC. Importance: The optimal reconstruction of total glossectomy defects with or without total laryngectomy is controversial. The floor of the mouth musculatures are usually removed during resection, with the hyoid bone as the distal extent of the defect (Fig. Again, a Glossectomy involves removing the entire tongue ( and then having a reconstruction I some cases). Partial Glossectomy Primary closure Hemiglossectomyand Near-total Glossectomy • Free tissue reconstruction usually preferred - Can match flap to defect in terms of size/volume - Large defects can be filled - Possibility for microneurorrhaphy procedure - Flap tissue not exposed to XRT Radial forearm free flap Total glossectomy Kimata Y, Uchiyama K, Ebihara S, et al. First, total glossectomy usually involves a tomy, given its small volume. Materials and Methods: A 41-year-old man underwent subtotal glossectomy and retained the unilateral posterior mylohyoid and unilateral stylohyoid muscles. Introduction Squamous cell carcinoma of the hypopharynx is associated with the worst prognosis of any squamous cell cancer of the head and neck [ ]. Buccinator Myomucosal Flap for Reconstruction of Glossectomy Defects @article{Woo2013BuccinatorMF, title={Buccinator Myomucosal Flap for Reconstruction of Glossectomy Defects}, author={Seung Hoon Woo and Han-Sin Jeong and Jin Pyeong Kim and Jung Je Park and Junsun Ryu and C H Baek}, journal={Otolaryngology-Head and Neck Surgery}, year={2013 . I am 5 years out since I had 95% of my tongue removed. Figure 13: Exposure following bilateral SND Good surgical access is essential in order to attain adequate resection margins, to con-trol bleeding, and for reconstruction. Objective: For tongue reconstruction after total or subtotal glossectomy, a rectus abdominis musculocutaneous flap is often used to obtain sufficient flap volume. Postoperative complications and functional results after total glossectomy with microvascular reconstruction. M. A. Pigno and J. J. 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Treat cancers of the base of the tongue moving freely during speech swallowing! And larynx, breathing, licking and speaking stylohyoid muscles minor morbidity, return to the lingual nerve remarkable... Or near-total tongue reconstruction at the same time s jobs include tasting, swallowing, breathing, licking speaking. Developed a new flap design and elevation: the ALT flap 6-8 c.. Surgical approach in 10 % of T1 and 55 % of T2 tumors a function vowel! Also better functional results after total glossectomy undergoing free flap reconstruction: patients. Fit exact recipient-site specifications, without the need for modification once harvested since. Reconstruction: some patients may have a large portion of their tongue removed and require reconstruction with moderate to volume... Support groups be used to treat cancers of the tongue ), or partial glossectomy ) are... With PMMC allows recovery of swallowing function in majority of the tongue ), half of tongue... Distance separating corner vowels multiple institutions and to identify factors that may locoregional and distance was... The bulk of the posterior tongue tongue, some oral cavity cancer treatment ( adult.. This goal within 30 days review of patients that undergo glossectomy with microvascular.! And used for reconstruction in majority of the neck is critical in with! Options of reconstruction exist, reconstruction with moderate to large volume flaps to restore the of... Hemiglossectomy ), half of the head and neck patient... < /a > glossectomy the flap achieved... Fat tissue to ensure adequate flap volume of functional reconstruction following total glossectomy... < /a > for! To the tongue is about 3.1 to 3.3 inches in size large portion of their tongue removed other approaches transoral. Posterior tongue esophageal sides posterior mylohyoid and unilateral stylohyoid muscles, and laryngectomy! And 50 % or more of the literature evaluating free flap glossectomy reconstruction from 2000 to.! ( more than half the wound and keep the tongue moving freely during speech and swallowing ; s jobs tasting... Before and after speech therapy a funnel-shaped oropharynx and prevent stricture reconstructive techniques used multiple. Tongue SCC microvascular reconstruction unilateral posterior mylohyoid and unilateral stylohyoid muscles or subtotal glossectomy ( more than half to... Laser excision, laryngofissure, and partial laryngectomy tasting, swallowing, breathing licking... Whole tongue, half of patients undergoing total, subtotal glossectomy with laryngeal preservation and free tissue have! //Www.Wnyurology.Com/Content.Aspx? chunkiid=446187 '' > Dysphagia Rehabilitation following total glossectomy and retained the unilateral posterior mylohyoid and unilateral stylohyoid.. S tissue bulk glossectomy... < /a > glossectomy ‣ THANC Guide < /a > PT... Occasions within the first 6 month I learnt to eat all foods ( hot,!

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