A Retrospective Evaluation of Partial Glossectomy for Early Tongue Cancer Using a Carbon Dioxide Laser

The purpose of this study was to retrospectively evaluate the postoperative results of partial glossectomy for early tongue cancer using a carbon dioxide laser (CO₂ laser).

CO₂ lasers are frequently used for the excision or treatment of soft tissue in a range of diseases, including oral cancer, leukoplakia, mucocele, anomalies of the labial and lingual frenum, and peri-implantitis.

We retrospectively reviewed 31 primary cases of early superficial tongue cancer that were treated using CO₂ lasers. In this study, early superficial cancer of the tongue is defined as a T1 or T2 tumor (TNM classification, NOMO; type, superficial spread, or exophytic; depth, <5 mm). The lesions were stained with 10% Lugol's solution and excised with a 5- or 10-mm safety margin from the nonstained area or induration using a CO₂ laser. The raw surface was covered with a polyglycolic acid sheet using fibrin glue spray (n = 23), sutures (n = 6), or both (n = 2). Five of the patients showed a bleeding tendency: 1 was taking warfarin 100 mg per day, 1 was taking 350 mg per day, 2 were taking aspirin 100 mg per day, and 1 was taking aspirin 200 mg per day.

There were no cases of postoperative bleeding. Regarding postoperative pain, all patients could stop taking analgesic drugs by 1 month after undergoing the operation. In regards to postoperative difficulty to swallow, all could start swallowing rice gruel 2 days after the operation. The surgical margin was unclear in two cases due to the thermal denaturation of the excisional margin. The 2-year local control rate was 100% and subsequent cervical lymph node metastasis rate was 6.5%.

In terms of recurrence, metastasis, postoperative bleeding, postoperative pain, and swallowing, partial glossectomy for early tongue cancer using a CO₂ laser might therefore help improve the postoperative course.