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Mandibular lingual releasing approach.

S P Stringer1, J R Jordan, W M Mendenhall

  • 1Department of Otolaryngology, University of Florida College of Medicine, Gainesville.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|September 1, 1992
PubMed
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The mandibular lingual releasing approach offers excellent visualization for oral and oropharyngeal tumor resection, preserving the mandible. This technique allows tumor delivery to the neck without bone cutting, demonstrating good oncologic outcomes and functional preservation.

Area of Science:

  • Head and Neck Surgery
  • Surgical Oncology
  • Oral Oncology

Background:

  • Oral cavity and oropharyngeal tumors pose significant surgical challenges.
  • Traditional approaches often involve mandibular resection, leading to functional deficits.
  • Minimally invasive techniques are sought to improve outcomes and preserve anatomy.

Purpose of the Study:

  • To evaluate the efficacy and safety of the mandibular lingual releasing approach for oral cavity and oropharyngeal tumors.
  • To assess the oncologic control and functional outcomes associated with this surgical technique.
  • To compare complication rates with and without prior radiation therapy.

Main Methods:

  • A retrospective review of 15 patients undergoing the mandibular lingual releasing approach between 1987 and 1991.

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  • Analysis of surgical visualization, margin status, recurrence rates, and functional outcomes (oral diet tolerance).
  • Documentation of postoperative complications, including fistulae and osteoradionecrosis, stratified by prior radiation status.

    • Main Results:

    • Excellent visualization was achieved, with 12 of 15 patients having clear resection margins.
    • Twelve patients maintained their weight via oral diet alone, indicating good functional preservation.
    • Complication rates were acceptable, particularly in previously irradiated patients, though osteoradionecrosis risk exists with high-dose postoperative radiation.

    Conclusions:

    • The mandibular lingual releasing approach is a viable technique for oral and oropharyngeal tumors, offering excellent visualization and preserving mandibular integrity.
    • The procedure facilitates tumor resection without mandibulotomy or mandibulectomy, leading to favorable functional outcomes.
    • While generally safe, careful consideration of radiation therapy is necessary to mitigate risks like osteoradionecrosis.