Skip to main content
Erschienen in: Oral and Maxillofacial Surgery 3/2017

19.05.2017 | Original Article

Compartmental tongue resection with submental island flap reconstruction for large carcinoma of the oral tongue

verfasst von: Sameh Roshdy, Mohamed Elbadrawy, Ashraf Khater, Islam A. Elzahaby, Tamer Fady, Hend A. El-Hadaad, Nazem Shams, Hany M. Elbarbary

Erschienen in: Oral and Maxillofacial Surgery | Ausgabe 3/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

Tongue resection is a surgical challenge because of its adverse effects on language articulation, swallowing, respiration, the eventual quality of life, and poor prognosis of advanced disease. To date, the currently accepted standard treatment has been based on excision of the primary lesion with a 1.5–2-cm circumferential macroscopic margin. Compartmental tongue surgery (CTS) is a surgical technique that removes an anatomo-functional compartment containing the primary tumor.

Methods and techniques

This is a prospective study that was carried out from June 2012 to January 2015 for patients with carcinoma affecting oral tongue. We enrolled all cases with ≥T2 tongue cancer with or without infiltration of floor of the mouth. Patients underwent compartmental tongue resection with reconstruction using island submental flap.

Results

Pharyngeal tear occurred in two cases that were repaired by simple suture. Bleeding occurred in two cases with control of the affected vessels. Loco-regional recurrence was detected only in two cases that underwent CTS, while 18 patients who underwent traditional tongue resection had local recurrence.

Conclusion

CTS via pull through technique with submental island flap reconstruction for large tongue cancer has been evolved to improve oncologic resections, obtaining a better local control of disease and increased survival rate with concomitant successful functional and esthetic outcomes especially in elderly patients with serious comorbidities.
Literatur
3.
Zurück zum Zitat Chong V (2005) Oral cavity cancer. Cancer imaging 5 spec no A:S49-52r Chong V (2005) Oral cavity cancer. Cancer imaging 5 spec no A:S49-52r
4.
Zurück zum Zitat Robertson AG, Soutar DS, Paul J, Webster M, Leonard AG, Moore KP, McManners J, Yosef HM, Canney P, Errington RD et al (1998) Early closure of a randomized trial: surgery and postoperative radiotherapy versus radiotherapy in the management of intra-oral tumours. Clin Oncol (RCollRadiol) 10:155–160CrossRef Robertson AG, Soutar DS, Paul J, Webster M, Leonard AG, Moore KP, McManners J, Yosef HM, Canney P, Errington RD et al (1998) Early closure of a randomized trial: surgery and postoperative radiotherapy versus radiotherapy in the management of intra-oral tumours. Clin Oncol (RCollRadiol) 10:155–160CrossRef
5.
Zurück zum Zitat Cooper JS, Pajak TF, Forastiere AA, Jacobs J, Campbell BH, Saxman SB, Kish JA, Kim HE, Cmelak AJ, Rotman M et al (2004) Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350:1937–1944CrossRefPubMed Cooper JS, Pajak TF, Forastiere AA, Jacobs J, Campbell BH, Saxman SB, Kish JA, Kim HE, Cmelak AJ, Rotman M et al (2004) Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350:1937–1944CrossRefPubMed
8.
Zurück zum Zitat Cook JA, Jones AS, Phillips DE (1993) Implications of tumor in resection margins following surgical treatment of squamous cell carcinoma of the head and neck. Clin Otolaryngol Allied Sci 18:37–41CrossRefPubMed Cook JA, Jones AS, Phillips DE (1993) Implications of tumor in resection margins following surgical treatment of squamous cell carcinoma of the head and neck. Clin Otolaryngol Allied Sci 18:37–41CrossRefPubMed
9.
Zurück zum Zitat Rana M, Iqbal A, Warraich R (2011) Modern surgical management of tongue carcinoma: a clinical retrospective research over a 12 years period. Head Neck Oncol 3:43CrossRefPubMedPubMedCentral Rana M, Iqbal A, Warraich R (2011) Modern surgical management of tongue carcinoma: a clinical retrospective research over a 12 years period. Head Neck Oncol 3:43CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Ren ZH, Wu HJ, Zhang S, Wang K, Gong ZJ, He ZJ, Peng J (2015) A new surgical strategy for treatment of tongue squamous cell carcinoma based on anatomic study with preliminary clinical evaluation. J Craniomaxillofac Surg 43(8):1577–1582. doi:10.1016/j.jcms.2015.07.034 CrossRefPubMed Ren ZH, Wu HJ, Zhang S, Wang K, Gong ZJ, He ZJ, Peng J (2015) A new surgical strategy for treatment of tongue squamous cell carcinoma based on anatomic study with preliminary clinical evaluation. J Craniomaxillofac Surg 43(8):1577–1582. doi:10.​1016/​j.​jcms.​2015.​07.​034 CrossRefPubMed
11.
12.
Zurück zum Zitat Hsiao SH, Lin HY, Lee MS, Li DK, Su NC, Lee CC et al (2009) Treatment results and prognostic factors for advanced oral tongue cancer. Tzu Chi Med J 21(1):52–58CrossRef Hsiao SH, Lin HY, Lee MS, Li DK, Su NC, Lee CC et al (2009) Treatment results and prognostic factors for advanced oral tongue cancer. Tzu Chi Med J 21(1):52–58CrossRef
13.
Zurück zum Zitat Piazza C, Del Bon F, Montalto N, Paderno A, Taglietti V, Grammatica A, Nicolai P (2014) Compartmental surgery for tongue tumors :oncologic and functional outcomes. NEW YORK, NY: 5th IFHNOS World Congress 2014 Piazza C, Del Bon F, Montalto N, Paderno A, Taglietti V, Grammatica A, Nicolai P (2014) Compartmental surgery for tongue tumors :oncologic and functional outcomes. NEW YORK, NY: 5th IFHNOS World Congress 2014
14.
Zurück zum Zitat Cheng Y-S, Li W-L, Xu L, Xu Z-F, Liu F-Y, Sun C-F (2013) Assessment of quality of life of oral cancer patients after reconstruction with radial forearm free flaps. Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 48(3):161–164PubMed Cheng Y-S, Li W-L, Xu L, Xu Z-F, Liu F-Y, Sun C-F (2013) Assessment of quality of life of oral cancer patients after reconstruction with radial forearm free flaps. Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 48(3):161–164PubMed
15.
Zurück zum Zitat Shah JP, Gil Z (2009) Current concepts in management of oral cancer—surgery. Oral Oncol 45(4–5):394–401CrossRefPubMed Shah JP, Gil Z (2009) Current concepts in management of oral cancer—surgery. Oral Oncol 45(4–5):394–401CrossRefPubMed
16.
Zurück zum Zitat Eckardt A, Meyer A, Laas U, Hausamen J-E (2007) Reconstruction of defects in the head and neck with free flaps: 20 years experience. Br J Oral Maxillofac Surg 45(1):11–15CrossRefPubMed Eckardt A, Meyer A, Laas U, Hausamen J-E (2007) Reconstruction of defects in the head and neck with free flaps: 20 years experience. Br J Oral Maxillofac Surg 45(1):11–15CrossRefPubMed
17.
Zurück zum Zitat Blanchaert RH Jr (2012) Survival after free flap reconstruction in patients with advanced oral squamous cell carcinoma. J Oral Maxillofac Surg 70(2):460CrossRefPubMed Blanchaert RH Jr (2012) Survival after free flap reconstruction in patients with advanced oral squamous cell carcinoma. J Oral Maxillofac Surg 70(2):460CrossRefPubMed
18.
Zurück zum Zitat Chen WL, Yang ZH, Huang ZQ, Wang YY, Wang YJ, Li JS (2007) Reverse facial artery-submental artery island myocutaneous flap for reconstruction of oral and maxillofacial defects following cancer ablation. Zhonghua Kou Qiang Yi Xue ZaZhi 42(10):629–630 Chen WL, Yang ZH, Huang ZQ, Wang YY, Wang YJ, Li JS (2007) Reverse facial artery-submental artery island myocutaneous flap for reconstruction of oral and maxillofacial defects following cancer ablation. Zhonghua Kou Qiang Yi Xue ZaZhi 42(10):629–630
19.
Zurück zum Zitat Merten SL, Jiang RP, Caminer D (2002) The submental artery island flap for head and neck reconstruction. ANZ J Surg 72(2):121–124CrossRefPubMed Merten SL, Jiang RP, Caminer D (2002) The submental artery island flap for head and neck reconstruction. ANZ J Surg 72(2):121–124CrossRefPubMed
20.
Zurück zum Zitat Martin D, Pascal JF, Baudet J, Mondie JM, Farhat JB, Athoum A (1993) The submental island flap: a new donor site. Anatomy and clinical applications as a free or pedicled flap. Plast Reconstr Surg 92(5):867–873CrossRefPubMed Martin D, Pascal JF, Baudet J, Mondie JM, Farhat JB, Athoum A (1993) The submental island flap: a new donor site. Anatomy and clinical applications as a free or pedicled flap. Plast Reconstr Surg 92(5):867–873CrossRefPubMed
21.
Zurück zum Zitat Elzahaby IA, Mohammed OH, Hafez MT, AbdElaziz SR, Mosbah MM, Refky BA (2013) Reconstruction of the lip commissure with upper and lower lip full-thickness defects using submental and nasolabial flaps: a case report. Annals of Oral & Maxillofacial Surgery 13(1):27 Elzahaby IA, Mohammed OH, Hafez MT, AbdElaziz SR, Mosbah MM, Refky BA (2013) Reconstruction of the lip commissure with upper and lower lip full-thickness defects using submental and nasolabial flaps: a case report. Annals of Oral & Maxillofacial Surgery 13(1):27
Metadaten
Titel
Compartmental tongue resection with submental island flap reconstruction for large carcinoma of the oral tongue
verfasst von
Sameh Roshdy
Mohamed Elbadrawy
Ashraf Khater
Islam A. Elzahaby
Tamer Fady
Hend A. El-Hadaad
Nazem Shams
Hany M. Elbarbary
Publikationsdatum
19.05.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Oral and Maxillofacial Surgery / Ausgabe 3/2017
Print ISSN: 1865-1550
Elektronische ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-017-0627-0

Weitere Artikel der Ausgabe 3/2017

Oral and Maxillofacial Surgery 3/2017 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.