Structural disturbance and reconstruction of glossectomy patients

Abstract

The tongue is a complex muscular organ that can alter greatly in shape. This ability to change form is directly derived from its complex architecture which consists of interweaving but distinct muscle groups. In turn, the tongue can carry out its essential functions of mastication, swallowing, and speech articulation. Understanding how the tongue functions requires systematic knowledge of its anatomy including the intrinsic and extrinsic muscles, their attachments, and relationship with the oral cavity and pharynx. A detailed description of the surgical anatomy of the tongue is provided to facilitate the surgeon in understanding the functional loss after resection. Surgery is carried out on the tongue most commonly for tongue cancer. In treating tongue cancer, surgical resection remains the primary modality. The extent of resection can vary greatly from a partial glossectomy to hemiglossectomy to total glossectomy. Patients at our head and neck cancer center, having undergone various types of glossectomy, present with a whole range of disturbed functions of the tongue. This disturbance not only depends on the extent of resection, but also the chosen method of surgical reconstruction. This chapter reviewed the extent of glossectomy required for varying sizes of tongue cancer, and also the various methods of reconstruction available. Moreover, a review of the post-operative functions of swallowing and speech is useful for the counseling of newly diagnosed tongue cancer patients and also for the rehabilitation of these patients.