Medical Dictionary     Glossectomy Definition    Send this page


  Free Full Text References 18 Dec 2007


Free Full Text ArticleManagement of the patients with early stage oral tongue cancers.
Related Articles

Management of the patients with early stage oral tongue cancers.

Tohoku J Exp Med. 2007 Aug;212(4):389-96

Authors: Shiga K, Ogawa T, Sagai S, Kato K, Kobayashi T

The incidence of oral cancer is increasing all over the world and tongue cancer is the most common type of oral cancer. However, standard treatment strategy for early stage tongue cancer has not yet been determined. To assess the appropriate therapy including elective neck dissection, a retrospective chart review of the patients were performed. Thirty-one patients with T1 or T2 tongue carcinomas were surgically treated in our hospital from 2001 through 2005. Twenty-one out of these patients were diagnosed as N0 by physical and diagnostic examinations. Three of 6 patients with T2N0 tumors who had undergone only partial glossectomy had recurrent tumors in the neck and died of disease. The disease-free survival rates at 40 months by Kaplan-Meier analysis were 100% and 60% for T1N0 and T2N0 patients, respectively, with a median follow-up time of 27 months for surviving patients. The depth of the tumor invasion and diameter of the tumors were analyzed. There was a significant difference between the frequency of nodal metastasis in patients with tumor less than 4 mm in depth and patients with tumors more than 4 mm in depth. These data indicate that elective neck dissection should be considered for treating patients with T2N0 tongue cancer because of the poorer prognosis of the patients if they did not undergo elective neck dissection, and that the depth of the tumor invasion is a critical factor for lymph node metastasis and preoperative evaluation of it might be an effective tool for the selection of the therapy.

PMID: 17660704 [PubMed - indexed for MEDLINE]


Free Full Text ArticleHypopharyngeal surgery in obstructive sleep apnea: an evidence-based medicine...
Related Articles

Hypopharyngeal surgery in obstructive sleep apnea: an evidence-based medicine review.

Arch Otolaryngol Head Neck Surg. 2006 Feb;132(2):206-13

Authors: Kezirian EJ, Goldberg AN

OBJECTIVE: To perform an evidence-based medicine review of the literature describing outcomes of hypopharyngeal surgery in obstructive sleep apnea. DESIGN: We performed a MEDLINE search of English-language articles or abstracts using the keywords sleep and surgery in combination with any of the following terms: hypopharynx, tongue, tongue base, epiglottis, genioglossus, advancement, mortised, genioplasty, glossectomy, tongue radiofrequency, hyoepiglottoplasty, hyoid, suspension, and stabilization. Additional studies were identified from their reference lists. We reviewed abstracts to select publications reporting outcomes of hypopharyngeal surgery in obstructive sleep apnea. Articles were included only if patients underwent treatment of the palate for suspected retropalatal obstruction. DATA EXTRACTION: Evidence-based medicine review for level of evidence, preoperative patient characteristics, surgical outcomes, and patient-specific factors associated with outcomes. RESULTS: We identified 36 articles. These were primarily case series studies (level 4 evidence), although some studies provided levels 1 and 2 evidence. Hypopharyngeal surgery demonstrates improvements in respiratory physiology during sleep, daytime somnolence, and quality of life. Several factors such as the body mass index, apnea-hypopnea index, Friedman stage, and SNB angle on lateral cephalogram have been associated with surgical outcomes. Considering the improvement in respiratory physiology alone, successful outcomes are achieved in 35% to 62% of patients; certain subgroups achieve higher success rates. CONCLUSIONS: Hypopharyngeal surgery in obstructive sleep apnea is associated with improved outcomes, although this benefit is supported largely by level 4 evidence. Future research should include larger, higher-level studies that consider the variety of treatment effects, compare surgical treatments, and identify factors associated with outcomes.

PMID: 16490881 [PubMed - indexed for MEDLINE]


Free Full Text ArticleIs glossectomy necessary for late nodal metastases without clinical local rec...
Related Articles

Is glossectomy necessary for late nodal metastases without clinical local recurrence after initial brachytherapy for N0 tongue cancer? A retrospective experience in 111 patients who received salvage therapy for cervical failure.

Jpn J Clin Oncol. 2006 Jan;36(1):3-6

Authors: Urashima Y, Nakamura K, Kunitake N, Shioyama Y, Sasaki T, Ooga S, Kuratomi Y, Yamamoto T, Kawazu T, Chikui T, Jingu K, Terashima H, Honda H

PURPOSE: To assess the efficacy of neck dissection (ND) without glossectomy (GL) for late nodal metastases without local recurrence after brachytherapy for N0 tongue cancer. MATERIALS AND METHODS: Among 396 patients with N0 tongue cancer treated with brachytherapy, a retrospective analysis was performed in 111 patients who were clinically diagnosed as having nodal metastases without local recurrence and whose neck lymph nodes turned out to be pathologically positive after salvage surgery. One hundred and five patients had undergone only ND (the ND group), six patients had undergone ND with GL (the ND+GL group). RESULTS: The 5 year disease-free and cause-specific survival rates after salvage therapy for the 111 patients included in this study were 58.1 and 61.9%, respectively. In the ND group, there were only nine patients who had local recurrence after ND. In addition, only six patients (5.7%) had a local recurrence within 2 years in the ND group. Sixty-three patients were free of disease after ND, 31 patients had regional or distant metastases without local recurrence and two patients had progressive disease at ND. In the ND+GL group, four patients were alive without disease and two died from regional or distant metastases. None of the patients in the ND+GL group were found to have malignant tissue in the pathological findings from the excised tongue. CONCLUSION: GL should be avoided or suspended when the clinical evaluation had revealed cervical failure without apparent local recurrence in the mobile tongue cancer patients after initial brachytherapy.

PMID: 16418183 [PubMed - indexed for MEDLINE]


Free Full Text ArticleGroup A beta-hemolytic streptococcal glossal necrotizing myositis--case repor...
Related Articles

Group A beta-hemolytic streptococcal glossal necrotizing myositis--case report and review.

MedGenMed. 2005;7(2):8

Authors: Baevsky RH, Ishida JT, Lieberman SA

We report the first case of glossal necrotizing myositis by group A beta-hemolytic Streptococcus in an 8-year-old girl on chronic nonsteroidal anti-inflammatory drugs, immunomodulators, and steroids for juvenile rheumatoid arthritis. Treatment included partial glossectomy and parenteral antibiotics. After a critical course, full recovery ensued. The subject of necrotizing myositis is reviewed.

PMID: 16369387 [PubMed - indexed for MEDLINE]


Free Full Text Article[Surgical management for occult cervical metastasis of oral tongue squamous c...
Related Articles

[Surgical management for occult cervical metastasis of oral tongue squamous cell carcinoma]

Ai Zheng. 2005 Mar;24(3):368-70

Authors: Guo ZM, Wang SL, Zeng ZY, Chen FJ, Zhang Q, Wei MW, Yang AK, Wu GH, Peng HW

BACKGROUND & OBJECTIVE: In oral tongue squamous cell carcinoma (SCC), the management for clinically negative (cN0) neck remains controversial. This study was to explore rational neck management for cN0 cases. METHODS: Clinical data of 187 patients with oral tongue SCC of cN0, who received surgery alone, were retrospectively reviewed. Rules of occult nodal metastasis, factors that impact cervical node metastasis, and prognostic factors were analyzed. Neck recurrences of different treatment groups were compared. RESULT: Incidence of occult nodal metastasis in all patients was 23.0% (43/187). The most common site of occult nodal metastases was ipsilateral level II. About 83.0% of occult nodal metastases were found in ipsilateral levels I, II, and III. Pathologic grade was an independent influencing factor for occult neck metastases. Occult neck metastasis was an independent prognostic factor for oral tongue SCC. Supraomohyoid neck dissection (SOHND) was an effective therapeutic method for oral tongue SCC of cN0; the neck recurrence rate after SOHND was only 6.7%. CONCLUSIONS: SOHND is the effective and safe treatment for oral tongue SCC.

PMID: 15757545 [PubMed - indexed for MEDLINE]


Free Full Text ArticleMasticatory efficiency before and after surgery in oral cancer patients: comp...
Related Articles

Masticatory efficiency before and after surgery in oral cancer patients: comparative study of glossectomy, marginal mandibulectomy and segmental mandibulectomy.

J Oral Sci. 2004 Jun;46(2):113-7

Authors: Namaki S, Matsumoto M, Ohba H, Tanaka H, Koshikawa N, Shinohara M

This study evaluated the effect of oral cancer surgery on masticatory efficiency. Masticatory efficiency was measured using the ATP absorption method. Eating ability was measured using a questionnaire. Two groups were employed as controls: The "normal occlusion group" consisted of subjects who had a complete set of natural maxillary teeth opposed to mandibular teeth, and the "unilateral occlusion group" consisted of subjects who had lost their molar and premolar teeth on one side of the mandible as a result of caries or periodontal diseases. Three treatment groups, each of 6 patients, were studied: a glossectomy group, a marginal mandibulectomy group and a segmental mandibulectomy group. There were no differences in masticatory efficiency between two control groups. Masticatory efficiencies of the three oral cancer treatment groups were lower than in the unilateral occlusion group, even 12 months after surgery. Masticatory efficiency of the glossectomy group was significantly higher 12 months after surgery compared with pre-surgery. Masticatory and eating abilities of the marginal mandibulectomy group and the segmental mandibulectomy were reduced at 3 and 6 months after surgery. The masticatory efficiency 12 months after surgery was higher in the marginal mandibulectomy group than the segmental mandibulectomy group, although the difference was not statistically significant. The self assessed eating ability 12 months after surgery was significantly higher in the marginal mandibulectomy group than the segmental mandibulectomy group. These results suggest that discontinuation of the mandible may lead patients to eat only foods that do not require a substantial amount of chewing. Hence, the quality of life of patients in the marginal mandibulectomy group was considered to be better than that in the segmental mandibulectomy group.

PMID: 15287545 [PubMed - indexed for MEDLINE]


Free Full Text ArticleSimultaneous expression of furin and vascular endothelial growth factor in hu...
Related Articles

Simultaneous expression of furin and vascular endothelial growth factor in human oral tongue squamous cell carcinoma progression.

Clin Cancer Res. 2004 Jul 1;10(13):4480-8

Authors: López de Cicco R, Watson JC, Bassi DE, Litwin S, Klein-Szanto AJ

PURPOSE: Squamous cell carcinoma (SCC) of the tongue is a common malignancy of the oral cavity. Furin convertase activates several precursor matrix metalloproteinases involved in the degradation of the extracellular matrix. The pattern of expression of furin and vascular endothelial growth factor-C (VEGF-C), two key molecules in neoplasm development, was examined during the progression from normal epithelium to invasive SCC. EXPERIMENTAL DESIGN: We evaluated furin and VEGF-C expression and microvessel density (MVD) by immunohistochemistry in human tongue sections harboring normal epithelium, dysplastic epithelium, and/or SCC. Sections from 46 glossectomy specimens were assessed for furin expression. A selected group of 15 cases, each containing normal epithelium, precursor lesions, and invasive SCC, were further studied for furin and VEGF-C expression and MVD quantification. We also evaluated the pattern of furin expression and VEGF-C processing by Western blot analysis in three SCC cell lines with different degrees of aggressiveness. RESULTS: Furin and VEGF-C expression was notably higher in most precursor lesions and SCCs than in normal epithelia. Approximately 60% (n = 26) and 100% (n = 15) of the normal epithelia showed low-intensity staining for furin and VEGF-C, respectively. Intense staining for furin and VEGF-C was detected in approximately 80% (n = 34) and 100% (n = 15) of the SCCs, respectively. A significant correlation was seen between the expression of these two markers (Spearman's test, P < 0.00002). We found a statistically significant increase in MVD when either dysplasia (432 +/- 19.06; P < 0.05) or SCC (546 +/- 17.24) was compared with normal epithelium (315 +/- 17.27; P < 0.0001). SCC71, the most aggressive cell line analyzed, was the one with the highest furin expression. This cell line totally processed the VEGF-C proform, whereas the less aggressive line SCC9, exhibiting the least furin expression, did not. SCC15, of intermediate aggressiveness and furin expression, showed intermediate pro-VEGF-C processing. CONCLUSIONS: These findings suggest that furin is a useful marker of tumor progression and is responsible for VEGF-C processing. This in turn would enhance angiogenesis, leading to increased MVD associated with preinvasive and invasive neoplasia.

PMID: 15240540 [PubMed - indexed for MEDLINE]


Free Full Text ArticlePartial glossectomy for lingual edema following injury.
Related Articles

Partial glossectomy for lingual edema following injury.

Indian Pediatr. 2004 May;41(5):520

Authors: Singh K

PMID: 15181313 [PubMed - indexed for MEDLINE]


Free Full Text ArticleCorrelating MRI and histologic tumor thickness in the assessment of oral tong...
Related Articles

Correlating MRI and histologic tumor thickness in the assessment of oral tongue cancer.

AJR Am J Roentgenol. 2004 Mar;182(3):803-8

Authors: Lam P, Au-Yeung KM, Cheng PW, Wei WI, Yuen AP, Trendell-Smith N, Li JH, Li R

OBJECTIVE: Tumor thickness in oral tongue cancer is an important independent prognostic factor for local recurrence, nodal metastasis, and patient survival. An accurate preoperative assessment of tumor thickness is therefore essential for optimal treatment planning. The aim of our study was to evaluate the accuracy of MRI findings for the preoperative measurement of tumor thickness. SUBJECTS AND METHODS. Eighteen patients with oral tongue cancer underwent preoperative MRI of the tongue. After surgery, the glossectomy specimens were serially sectioned. The radiologic tumor thickness of contrast-enhanced T1-weighted and T2-weighted images was compared with the histologic tumor thickness using our proposed tumor thickness staging classifications. These included stage I (tumor < or = 3 mm), stage II (> 3 mm but < or = 9 mm) and stage III (> 9 mm). RESULTS: The overall accuracy in assessment of proposed tumor thickness staging using contrast-enhanced T1-weighted and T2-weighted images was 83% and 56%, respectively. The radiologic tumor thickness as measured on contrast-enhanced T1-weighted and T2-weighted images had significant correlation with histologic tumor thickness (R = 0.938 and 0.941, respectively). CONCLUSION: MR images provide satisfactory accuracy for the measurement of tumor thickness and staging of oral tongue cancer. Preoperative MRI is recommended to assist in treatment planning for patients with this disease.

PMID: 14975989 [PubMed - indexed for MEDLINE]


Free Full Text ArticleMacroglossia.
Related Articles

Macroglossia.

Indian Pediatr. 2003 Dec;40(12):1206

Authors: Dubey AK, Sodhi K

PMID: 14722375 [PubMed - indexed for MEDLINE]


Free Full Text ArticleMuscle tissue engineering for partial glossectomy defects.
Related Articles

Muscle tissue engineering for partial glossectomy defects.

Arch Facial Plast Surg. 2003 Sep-Oct;5(5):403-7

Authors: Kim J, Hadlock T, Cheney M, Varvares M, Marler J

BACKGROUND: Tongue reconstruction represents a difficult reconstructive problem, based on the tongue's complex multimodality function. Existing methods of tongue reconstruction often result in significant deficits in speech and deglutition. A functional neotongue requires adequate soft tissue bulk and restoration of coordinated muscle function. Tissue engineering, a scientific approach that allows introduction of isolated cell populations of interest within 3-dimensional polymer scaffolds to create new tissue, may allow the generation of more highly functional tissue in tongue reconstruction. OBJECTIVES: To apply muscle-tissue engineering techniques in the reconstruction of partial glossectomy defects in rats, and to compare the gross and histological nature of tissue found after reconstruction of the hemiglossectomy defect with acellular vs tissue-engineered composite material. MATERIALS AND METHODS: Thirty mature Lewis rats underwent a left-sided mucosa-sparing partial glossectomy. The defects were then filled with 1 of the following 3 substances: isotonic sodium chloride solution, a collagen-rich hydrogel, or hydrogel containing a suspension of neonatal myoblasts from syngeneic rats. The animals were killed after 6 weeks and the tongues were harvested. The control and operated-on tongue halves were evaluated for weight differences and histological features. RESULTS: The group receiving the hydrogel-myoblast composite injections demonstrated a statistically significant increase in tongue weight of the operated-on side compared with the control side. In contrast, the isotonic sodium chloride solution and hydrogel groups demonstrated loss of tongue weight. These findings correlated with the results of the histological evaluation. Hemitongues from the composite group demonstrated formation of new tissue with areas of musclelike tissue extending from islands of residual hydrogel, and we found evidence of neovascularization and possible neurotization. In contrast, the isotonic sodium chloride solution group exhibited dense fibrous scar with loss of muscle architecture and dramatic loss of tongue volume. The hydrogel group demonstrated preservation of tongue volume with persistent islands of gel, but no clear evidence of new tissue formation. CONCLUSIONS: The introduction of a hydrogel into the rat hemiglossectomy pocket appears to promote volume preservation and/or muscle regeneration. The addition of myoblasts suspended in collagen gel supports the development of new tissue that preserves weight and volume after hemiglossectomy and may possess muscle properties similar to the tissue desired. This tissue-engineering approach represents a promising new strategy in tongue reconstruction and merits further investigation into the possible functional advantages it offers compared with current techniques.

PMID: 12975138 [PubMed - indexed for MEDLINE]


Free Full Text Article[Surgical tongue-base suspension for obstructive sleep apnea syndrome. Our ex...
Related Articles

[Surgical tongue-base suspension for obstructive sleep apnea syndrome. Our experience]

Acta Otorrinolaringol Esp. 2002 Nov;53(9):666-73

Authors: Naya MJ, Vicente EA, As&#xED;n J, Gargallo P

There are a lot of techniques involves to surgical treatment of the Obstructive Sleep Apnea Syndrome. Surgical treatments of tongue-base and hypopharyngeal colapse include glossectomy, hyoid suspension, mandibular osteotomy with genioglossal advancement and maxillay-mandibular advancement. Many or these procedures are associated with extreme morbidity. In this paper is evaluated the effectiveness of a minimally invasive technique for tongue-base suspension. The procedure was performed in 12 male patients whit O.S.A.S. that were evaluated with cefalometric and fiberoptic analysis. These preliminary results show the initial efficacy of this new surgical procedure.

PMID: 12584882 [PubMed - indexed for MEDLINE]


Free Full Text ArticlePercutaneous ethanol sclerotherapy of venous malformations of the tongue.
Related Articles

Percutaneous ethanol sclerotherapy of venous malformations of the tongue.

AJNR Am J Neuroradiol. 2002 May;23(5):779-82

Authors: Johnson PL, Eckard DA, Brecheisen MA, Girod DA, Tsue TT

BACKGROUND AND PURPOSE: Percutaneous ethanol sclerotherapy has been reported to be efficacious for head and neck venous malformations. We sought to evaluate the safety and efficacy of percutaneous sclerotherapy by using ethanol for treatment of symptomatic venous malformations of the tongue. METHODS: Eleven sclerotherapy procedures were performed in seven patients from January 1995 to February 2001. Patient age ranged from 19 months to 57 years (mean age, 32 years). Four patients were male and three were female. Mean follow-up was 36 months. The volume of ethanol used per treatment session ranged from 2 to 32 cc (mean, 16 cc). RESULTS: Sclerotherapy provided significant improvement or resolution of symptoms for all patients. There were no major complications. One patient had a small (3 x 2 cm) area of skin blistering at the injection site. All patients experienced pain and swelling to a variable degree. Sclerotherapy resulted in resolution of symptoms in six of seven patients. Three patients had resolution of symptoms after one procedure. Four patients each underwent two sclerotherapy procedures. One patient who remained symptomatic but improved after undergoing two procedures underwent an anterior glossectomy and is now asymptomatic. CONCLUSION: Percutaneous ethanol sclerotherapy is a safe and effective method of treating symptomatic venous malformations of the tongue.

PMID: 12006276 [PubMed - indexed for MEDLINE]


Free Full Text ArticleIrradiated carcinoma of the tongue: correlation of MR imaging findings with p...
Related Articles

Irradiated carcinoma of the tongue: correlation of MR imaging findings with pathology.

AJR Am J Roentgenol. 2002 Mar;178(3):705-10

Authors: Tomura N, Watanabe O, Kato K, Takahashi S, Watarai J, Sageshima M, Yokomizo M

OBJECTIVE: MR imaging was prospectively correlated with pathologic findings to study whether MR imaging can differentiate viable from nonviable tumor tissue in the irradiated carcinoma of the tongue. SUBJECTS AND METHODS: MR examinations were performed after radiation therapy in 21 patients with carcinoma of the tongue. All patients underwent either a total glossectomy or hemiglossectomy after radiation therapy. Specimens were examined microscopically. Radiation changes were histologically graded into four groups (I, minimal cellular changes; II, presence of cellular changes and partial destruction of the tumor; III, only nonviable tumor cells; IV, no tumor cells). MR examinations included T2-weighted imaging, unenhanced T1-weighted imaging, dynamic contrast-enhanced imaging, and contrast-enhanced T1-weighted imaging. RESULTS: On unenhanced T1-weighted images, the lesion was hypointense, except for two patients with histologic grade III. On T2-weighted images, the lesion appeared hyperintense in 12 of 14 patients with viable tumor cells (grades I and II); however, the lesion was hypointense in four, and isointense in two of seven patients with nonviable tumor cells (grades III or IV). Contrast-enhanced T1-weighted images showed that the degree of contrast enhancement of the lesion was equal to or lower than that of a normal salivary gland in 18 of 21 patients. For the time of maximal enhancement of the lesion on dynamic imaging, there was no substantial difference between viable (grades I and II) and nonviable (grades III and IV) tumor tissue. CONCLUSION: The present study shows that T2-weighted imaging is feasible for differentiating viable from nonviable tumor tissue in irradiated carcinoma of the tongue.

PMID: 11856702 [PubMed - indexed for MEDLINE]


Free Full Text ArticleSensate radial forearm free flaps in tongue reconstruction.
Related Articles

Sensate radial forearm free flaps in tongue reconstruction.

Arch Otolaryngol Head Neck Surg. 2001 Dec;127(12):1463-6

Authors: Kuriakose MA, Loree TR, Spies A, Meyers S, Hicks WL

BACKGROUND: Successful rehabilitation after ablative surgery requires not only the reconstruction of 3-dimensional form but also the restoration of physiologic function. OBJECTIVE: To assess sensory recovery of reinnervated radial forearm flaps used for tongue reconstruction. PATIENTS AND METHODS: Seventeen patients, who underwent reconstruction of glossectomy defects with reinnervated radial forearm free flaps, formed the study group. Recovery of sensation was measured by both subjective and detailed objective tests 8 months after surgery. Sensory function of the flap was compared with that of the normal residual tongue or the adjacent oral mucosa and the contralateral forearm donor site. RESULTS: All patients involved in this study had tongue defects of hemiglossectomy or greater and adjacent floor of the mouth. Sensory recovery was observed in all of the 17 patients within 8 months. Detailed sensory testing showed that median static 2-point discrimination, moving 2-point discrimination, and pressure sensitivity (1.2 cm, 0.8 cm, and 3.7 psi, respectively) were subjectively greater in the innervated forearm flaps than in the contralateral forearm donor site (2.3 cm, 1.7 cm, and 4.6 psi, respectively) (P= .064) and similar to those of the normal tongue (0.9 cm, 0.5 cm, and 3.6 psi). CONCLUSIONS: In all modalities examined, sensate free flaps proved superior in sensory fidelity to the native forearm donor site and closely approached that of the normal tongue. Microsurgical reinnervation of flaps should be considered in tongue reconstruction.

PMID: 11735815 [PubMed - indexed for MEDLINE]


Free Full Text ArticleSpeech intelligibility after glossectomy and speech rehabilitation.
Related Articles

Speech intelligibility after glossectomy and speech rehabilitation.

Arch Otolaryngol Head Neck Surg. 2001 Jul;127(7):877-83

Authors: Furia CL, Kowalski LP, Latorre MR, Angelis EC, Martins NM, Barros AP, Ribeiro KC

BACKGROUND: Oral tumor resections cause articulation deficiencies, depending on the site, extent of resection, type of reconstruction, and tongue stump mobility. OBJECTIVES: To evaluate the speech intelligibility of patients undergoing total, subtotal, or partial glossectomy, before and after speech therapy. PATIENTS AND METHODS: Twenty-seven patients (24 men and 3 women), aged 34 to 77 years (mean age, 56.5 years), underwent glossectomy. Tumor stages were T1 in 3 patients, T2 in 4, T3 in 8, T4 in 11, and TX in 1; node stages, N0 in 15 patients, N1 in 5, N2a-c in 6, and N3 in 1. No patient had metastases (M0). Patients were divided into 3 groups by extent of tongue resection, ie, total (group 1; n = 6), subtotal (group 2; n = 9), and partial (group 3; n = 12). Different phonological tasks were recorded and analyzed by 3 experienced judges, including sustained 7 oral vowels, vowel in a syllable, and the sequence vowel-consonant-vowel (VCV). The intelligibility of spontaneous speech (sequence story) was scored from 1 to 4 in consensus. All patients underwent a therapeutic program to activate articulatory adaptations, compensations, and maximization of the remaining structures for 3 to 6 months. The tasks were recorded after speech therapy. To compare mean changes, analyses of variance and Wilcoxon tests were used. RESULTS: Patients of groups 1 and 2 significantly improved their speech intelligibility (P<.05). Group 1 improved vowels, VCV, and spontaneous speech; group 2, syllable, VCV, and spontaneous speech. Group 3 demonstrated better intelligibility in the pretherapy phase, but the improvement after therapy was not significant. CONCLUSIONS: Speech therapy was effective in improving speech intelligibility of patients undergoing glossectomy, even after major resection. Different pretherapy ability between groups was seen, with improvement of speech intelligibility in groups 1 and 2. The improvement of speech intelligibility in group 3 was not statistically significant, possibly because of the small and heterogeneous sample.

PMID: 11448366 [PubMed - indexed for MEDLINE]


Free Full Text ArticleVideo fluoroscopic evaluation after glossectomy.
Related Articles

Video fluoroscopic evaluation after glossectomy.

Arch Otolaryngol Head Neck Surg. 2000 Mar;126(3):378-83

Authors: Furia CL, Carrara-de Angelis E, Martins NM, Barros AP, Carneiro B, Kowalski LP

BACKGROUND: The swallowing deficits that result from oral or oropharyngeal resections vary considerably depending on the site, extension of the resection, and type of reconstruction. Most patients will experience some degree of dysphagia despite the reconstructive effort. Furthermore, a glossectomy is frequently associated with voice and speech difficulties. OBJECTIVES: To characterize swallowing in patients who underwent a glossectomy and to define the limits and the compensatory movements using video fluoroscopic analysis. DESIGN AND SETTING: Video fluoroscopic evaluation of 15 patients who underwent glossectomies at the Centro de Tratamento e Pesquisa Hospital do Cancer A. C. Camargo, S*ao Paulo, Brazil. PATIENTS: We examined 15 patients: 5 who underwent a partial glossectomy, 2 who underwent a subtotal glossectomy, and 8 who underwent a total glossectomy with laryngeal preservation and reconstruction with myocutaneous flaps (9 pectoralis major flaps and 1 latissimus dorsi flap). The 15 patients were enrolled in a program that included voice, speech, and swallowing rehabilitation. RESULTS: All patients who underwent a partial glossectomy had difficulties with formation and anteroposterior propulsion of the bolus in the oral cavity and an increase in oral transit time, which was more evident with materials of thicker consistencies. All patients who underwent a total or subtotal glossectomy with laryngeal preservation had an increase in oral transit time and stasis of food in the oral cavity, the pharynx, and the superior esophageal sphincter. Of the 15 patients, 2 had moderate and asymptomatic aspiration. These 2 patients had swallowing compensations, such as increased buccal, mandibular, pharyngeal, and laryngeal activity and voluntary protection of the larynx during swallowing. CONCLUSIONS: This study demonstrates the effectiveness of swallowing in patients who were enrolled in voice, speech, and swallowing rehabilitation after undergoing a partial or total glossectomy. An increase in oral transit time was detected in all patients. Only 2 of the 10 patients who underwent a total glossectomy had persistent asymptomatic aspiration.

PMID: 10722012 [PubMed - indexed for MEDLINE]


Free Full Text ArticleFailure of cricopharyngeal myotomy to improve dysphagia following head and ne...
Related Articles

Failure of cricopharyngeal myotomy to improve dysphagia following head and neck cancer surgery.

Arch Otolaryngol Head Neck Surg. 1999 Sep;125(9):942-6

Authors: Jacobs JR, Logemann J, Pajak TF, Pauloski BR, Collins S, Casiano RR, Schuller DE

OBJECTIVE: To determine whether cricopharyngeal myotomy can improve dysphagia associated with head and neck cancer surgery. DESIGN: Prospective, randomized, multicenter trial. SETTING: Twelve clinical sites across the United States. PATIENTS: Between 1989 and 1994, 125 patients undergoing combined modality therapy for head and neck cancer, including resection of the tongue base or supraglottic larynx, were prospectively entered into the trial. INTERVENTION: Cricopharyngeal myotomy on a randomized basis. MAIN OUTCOME MEASURES: Videofluoroscopic examination to determine oropharyngeal swallowing efficiency, which is defined as the ratio of percentage of the bolus swallowed to total swallowing time using 3 different bolus consistencies. RESULTS: No significant difference in oropharyngeal swallowing efficiency between myotomy vs no myotomy was seen at 6 months of follow-up regardless of bolus consistency. CONCLUSIONS: In this prospective test of cricopharyngeal myotomy, the procedure fails to significantly improve dysphagia associated with head and neck cancer surgery. The efficacy of this surgical procedure in other disease entities should also be rigorously explored.

PMID: 10488976 [PubMed - indexed for MEDLINE]


Free Full Text ArticleThe difference between delayed extubation and tracheostomy in post-operative ...
Related Articles

The difference between delayed extubation and tracheostomy in post-operative sleep apnea after glossectomy or laryngectomy.

Jpn J Clin Oncol. 1999 Mar;29(3):127-31

Authors: Saito T, Den S, Hiraga K, Uchiyama K, Carlsson C

BACKGROUND: Patients with cancer of the tongue or larynx require glossectomies or laryngectomies and subsequent reconstruction. These procedures remove part of the patient's upper airway. In cancer of the tongue, the removed part of the airway is substituted by a flap of their skin. Post-operatively, it is possible that the patients have problems respiring comfortably. In addition to this, long surgical procedures may simply interfere with their circadian rhythm. To elucidate the possible change in their post-operative respiration, we monitored the patient's respiratory pattern with an apnea monitor. METHODS: We attached an apnea monitor to the patients and recorded their respiratory pattern and arterial oxygen saturation. The patients were monitored for a total of five days: three days prior to the operation, one day before the operation, the day of operation, two days after, and on the fourth day after the operation. The period of monitoring was from 8:00 p.m. to 6:00 a.m. the next morning. RESULTS: Sixteen patients completed this study. The patients whose tube was extubated after glossectomy showed frequent apnea, low mean oxygen saturation and low comfort score as compared to the patients with tracheostomy after laryngectomy. Because two failed cases of free skin flap were among the former, it is possible that the frequent apnea is a factor of failed free skin graft after glossectomy and laryngectomy. CONCLUSION: Further studies are required to improve the patient's respiration during their sleep after tracheal extubation in glossectomy.

PMID: 10225694 [PubMed - indexed for MEDLINE]


Free Full Text ArticleSurgical criteria for obstructive sleep apnea syndrome based on localization ...
Related Articles

Surgical criteria for obstructive sleep apnea syndrome based on localization of upper airway collapse during sleep: a preliminary study.

Tohoku J Exp Med. 1998 May;185(1):1-8

Authors: Ikeda K, Oshima T, Shimomura A, Takasaka T

Obstructive sleep apnea syndrome (OSAS) is defined as intermittent complete or partial upper airway obstruction during sleep, causing mental and physical effects. Localization of obstructions in the upper airways in OSAS patients provides indispensable information for the selection of surgical procedures. We measured the pressure within the upper airways during sleep in 6 patients with OSAS in order to select the surgical procedure. Five patients were found to have the airway collapse in the velopharynx, and in three of them underwent uvulopalatopharyngoplasty (UPPP) with tonsillectomy was performed. The remaining one patient, having an obstruction in both the velopharynx and hypopharynx, underwent laser-assisted midline glossectomy as well as UPPP. The 4 patients receiving the operation showed improvements in the sleep apnea index and the lowest oxygen saturation postoperatively. These findings suggest that pressure measurement may be a reliable tool for localizing obstructions in OSAS patients and may be used for determined the surgical option.

PMID: 9710939 [PubMed - indexed for MEDLINE]


Free Full Text ArticleThyroid gland after total laryngectomy: CT appearance.
Related Articles

Thyroid gland after total laryngectomy: CT appearance.

Radiology. 1998 May;207(2):405-9

Authors: Weissman JL, Curtin HD, Johnson JT

PURPOSE: To determine the computed tomographic (CT) appearance of the normal thyroid gland after total laryngectomy, because the high attenuation (or heterogeneous attenuation) of thyroid parenchyma was misinterpreted as tumor on several CT studies. MATERIALS AND METHODS: A search of computerized clinical files compiled from January 1996 through August 1997 yielded data on 24 patients who had undergone laryngectomy and subsequent CT of the neck. From these 24 patients, CT findings were available in 21. Because one patient had undergone total thyroidectomy and was excluded from the study, a retrospective review was performed in the remaining 20 patients. RESULTS: In 14 patients, unilateral thyroid tissue was present; in the other six there was bilateral thyroid tissue not connected by an isthmus. Thus, there were 26 remaining thyroid lobes, of which six were round and 20 were oval or lobular. Nineteen lobes showed homogeneously high attenuation (including one scanned without use of contrast material), six showed heterogeneous high attenuation or contained areas of hyperlucency, and one was obscured by streak artifact. CONCLUSION: Thyroid tissue can appear as unilateral or bilateral asymmetric masses on neck CT scans after laryngectomy. Gland tissue can show homogeneously or heterogeneously high attenuation. Familiarity with the varied postoperative appearance of normal thyroid gland can prevent its misdiagnosis as tumor.

PMID: 9577488 [PubMed - indexed for MEDLINE]


Free Full Text ArticleTumor thickness predicts cervical metastasis in patients with stage I/II carc...
Related Articles

Tumor thickness predicts cervical metastasis in patients with stage I/II carcinoma of the tongue.

Cancer. 1998 Apr 15;82(8):1443-8

Authors: Asakage T, Yokose T, Mukai K, Tsugane S, Tsubono Y, Asai M, Ebihara S

BACKGROUND: The incidence of cervical metastases after surgery for Stages I/II carcinoma of the tongue is 30-40%. Postoperative cervical metastases are an adverse prognostic factor for patients with this malignancy. The purpose of this study was to evaluate the clinicopathologic factors associated with late cervical metastases in patients with carcinoma of the tongue. METHODS: The clinicopathologic features of 44 patients with previously untreated Stage I/II carcinoma of the tongue were reviewed. All patients were treated with partial glossectomy only. RESULTS: Cervical metastases developed in 21 of 44 patients within 5 years. Factors significantly associated with the development of cervical metastases were invasive growth, differentiation, nuclear polymorphism in the deep portion, tumor border, nest formation, infiltrative growth ratio, depth, and thickness. No statistical correlations between cervical metastases and age, gender, tumor location, clinical stage, Brinkman index, alcohol index, mitosis, connective tissue, lymphocytic infiltration, or perineural invasion were found. Multivariate analysis demonstrated that only tumor thickness > 4 mm had a predictive value for cervical metastasis (risk ratio 9.4; 95% confidence interval, 1.5-57.7). CONCLUSIONS: The current study data indicate that patients with Stage I/II carcinoma of the tongue > 4 mm in thickness are at increased risk for subsequent cervical metastasis. Thus, conservative supraomohyoid neck dissection is indicated in patients with Stage I/II carcinoma of the tongue > 4 mm in thickness.

PMID: 9554518 [PubMed - indexed for MEDLINE]


Free Full Text ArticleRadiofrequency volumetric reduction of the tongue. A porcine pilot study for ...
Related Articles

Radiofrequency volumetric reduction of the tongue. A porcine pilot study for the treatment of obstructive sleep apnea syndrome.

Chest. 1997 May;111(5):1348-55

Authors: Powell NB, Riley RW, Troell RJ, Blumen MB, Guilleminault C

STUDY OBJECTIVE: To investigate, in an animal model, the feasibility of radiofrequency (RF) volumetric tongue reduction for the future purpose of determining its clinical applications in obstructive sleep apnea syndrome (OSAS). DESIGN: The study was performed in three stages, one in vitro bovine stage and two in vivo porcine stages. The last stage was a prospective investigation with histologic and volumetric analyses to establish outcomes. SETTING: Laboratory and operating room of veterinary research center. PARTICIPANTS: A homogeneous population of porcine animal models, including seven in stage 2 and 12 in stage 3. INTERVENTION: RF energy was delivered by a custom-fabricated needle electrode and RF generator to the tongue tissue of both the in vitro and in vivo models. MEASUREMENTS AND RESULTS: Microultransonic crystals were used to measure three-dimensional changes (volumetric reduction). Lesion size correlated well with increasing RF energy delivery (Sperman correlation coefficient of 0.986; p = 0.0003). Histologic assessments done serially over time (1 h through 3 weeks) showed a well-circumscribed lesion with a normal healing progression and no peripheral damage to nerves. Volumetric analysis documented a very mild initial edematous response that promptly tapered at 24 h. At 10 days after RF, a 26.3% volume reduction was documented at the treatment site (circumscribed by the microultrasonic crystals). CONCLUSION: RF, in a porcine animal model, can safely reduce tongue volume in a precise and controlled manner. Further studies will validate the use of RF in the treatment of OSAS.

PMID: 9149593 [PubMed - indexed for MEDLINE]


Free Full Text ArticleMacroglossia.
Related Articles

Macroglossia.

BMJ. 1994 Nov 26;309(6966):1386-7

Authors: Murthy P, Laing MR

PMID: 7819836 [PubMed - indexed for MEDLINE]


Free Full Text ArticleSquamous-cell carcinoma of the tongue: preoperative interstitial radium and e...
Related Articles

Squamous-cell carcinoma of the tongue: preoperative interstitial radium and external irradiation. Part I: Local and regional control.

Radiology. 1984 May;151(2):499-503

Authors: Vermund H, Brennhovd IO, Kaalhus O, Poppe E

Results of therapy in 300 patients with squamous-cell carcinoma of the anterior two thirds of the tongue are presented in terms of control of the primary tumor (local) and metastases to the lymph nodes of the neck (regional). Correlation between clinical stage and control was good, with the best results being obtained in stage T1N0 (84% control of tongue, 69% control of neck) and the poorest results in TX N2N3 (9% and 11%, respectively). Different methods of treatment were analyzed separately for various stages of disease and compared with results from other institutions. Possible methods of improving treatment are discussed.

PMID: 6424175 [PubMed - indexed for MEDLINE]


Free Full Text ArticleComputed tomography of the tongue and floor of the mouth.
Related Articles

Computed tomography of the tongue and floor of the mouth.

Radiology. 1982 May;143(2):493-500

Authors: Larsson SG, Mancuso A, Hanafee W

The anatomy of the tongue and floor of the mouth is readily discernible by computed tomography (CT) because of low-density fascial planes that outline the extrinsic musculature, lingual arteries, and hypoglossal nerves. Although the tongue is accessible to the examining finger, few patients can tolerate a detailed palpation. In planning for a partial glossectomy, CT scanning aids the surgeon who must be sure that the tumor is unilateral or that at least one lingual artery and one hypoglossal nerve can be preserved. The CT scans of 30 patients were reviewed for background anatomy. Pathologic changes are summarized for 16 extrinsic lesions and 11 intrinsic tumors. The status of the midline could be confirmed in 28 of the 30 patients. The fascial plane distortions by malignant intrinsic and extrinsic lesions are discussed.

PMID: 7071353 [PubMed - indexed for MEDLINE]


Free Full Text ArticleIn vitro closure of the rat palate.
Related Articles

In vitro closure of the rat palate.

J Dent Res. 1966 Sep-Oct;45(5):1375-80

Authors: Reeve WL, Porter K, Lefkowitz W

PMID: 5225493 [PubMed - indexed for MEDLINE]



  Translate a Phrase or Word
  
  from

Adapted MeSH Browser © Dentalarticles.com | Disclaimer