Cortical adaptation following partial glossectomy with primary closure: implications for reconstruction of the oral tongue.
OBJECTIVE
The considerable variability in functional outcomes for speech and swallowing with different reconstruction techniques following partial glossectomy may reflect the ability of patients to adapt to altered tongue structure. The purpose of this study was to determine mechanisms of cortical adaptation in swallowing to partial glossectomy reconstructed with primary closure.


METHODS
Four patients treated with partial glossectomy and primary closure underwent functional magnetic resonance imaging at a mean of 6 months after operation, and the data were compared to those from 8 healthy controls.


RESULTS
Statistically significant increases in activity occurred predominately in the parietal cortices and the cerebellum. The volume of the resection was most highly correlated with activity in the premotor and parietal cortices and cerebellum.


CONCLUSIONS
The adaptive changes in the cortex following partial glossectomy with primary closure reflect adaptation to the biomechanics of tongue movement during swallowing, and not altered sensation in the tongue.
Mosier
Kristine
K
Department of Radiology, Division of Otolaryngology-Head and Neck Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, USA.
Liu
Wen-Ching
WC
Behin
Babak
B
Lee
Christopher
C
Baredes
Soly
S
D000222:Adaptation, Physiological; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D002525:Cerebellar Cortex / Q000502:physiology*; D015331:Cohort Studies; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D005927:Glossectomy / Q000009:adverse effects; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000502:physiology; D010296:Parietal Lobe / Q000502:physiology*; D019651:Plastic Surgery Procedures; D013064:Speech Disorders / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D014059:Tongue / Q000502:physiology / Q000601:surgery*; D016896:Treatment Outcome