The procedure of total glossectomy for surgical management of such locally advanced cancer of the tongue is always challenging.
Total glossectomy is a surgical option for patients with advanced (stage IV cancers) or recurrent tongue cancer. Advanced cancer of the tongue has severe repercussions to function and survival of the affected patients. This procedure is most commonly performed for oncologic control.
The patient, a 53-year-old male affected by carcinoma of base of tongue, was referred to Dr. Mathan Mohan. After extensive clinical and laboratory examination, Dr. Mathan nominated the patient for Total Glossectomy (entire tongue removal) with PMMC flap reconstruction.
The procedure of total glossectomy for surgical management of such locally advanced cancer of the tongue is always challenging and often carries significant comorbidities.
A perioperative tracheostomy was performed to bypass an obstructed upper airway. Bilateral neck dissection was performed, and the surgical approach was a mandibular lingual release approach. The entire tongue was removed and reconstructed with a Pectoralis Major Myocutaneous (PMMC) flap. Although several options of reconstruction exist, reconstruction with PMMC allows recovery of swallowing function in majority of the patients. The flap was harvested from the left chest and used for reconstruction.
Percutaneous endoscopic gastrostomy (PEG) was performed before the surgery to provide an enhanced means of feeding.
Patient was referred to therapist to learn to speak and swallow after surgery.
Total glossectomy is a successful treatment regimen for patients with advanced cancer of the tongue as a primary treatment. This procedure may lead to satisfactory oral function with regard to the intelligibility of speech and swallowing.