Total glossectomy sans laryngectomy--are we justified?

Area of Science:

• Oncology
• Otolaryngology
• Surgical Oncology

Background:

• Tongue cancer presents a significant challenge in head and neck oncology.
• Total glossectomy is a radical surgical approach for advanced tongue cancer.
• Larynx preservation is a critical consideration in glossectomy outcomes.

Purpose of the Study:

• To evaluate the outcomes of total glossectomy in 85 tongue cancer patients.
• To assess the impact of larynx preservation on functional results and complications.
• To identify factors influencing local recurrence and mortality.

Main Methods:

• Retrospective review of 85 patients undergoing total glossectomy for tongue cancer.
• Analysis of surgical techniques, including concurrent neck dissection and laryngectomy.
• Evaluation of postoperative complications, local recurrence rates, and survival data.

Main Results:

• Squamous cell carcinoma was the predominant histology (82 cases).
• Larynx was preserved in 75 cases; 4% mortality from aspiration pneumonitis.
• Local recurrence rates varied: 42% for posterior lesions, 27% for anterior lesions.
• Speech was understandable despite not being fully articulate.

Conclusions:

• Larynx preservation in total glossectomy is generally worthwhile and justifiable.
• Careful patient selection is essential, avoiding larynx preservation in cases with extensive pharyngeal involvement or high aspiration risk.
• Total glossectomy offers functional speech outcomes, with recurrence rates dependent on lesion location.