[Swallowing and laryngeal function preserving in surgical treatment of the head and neck tumors involving the tongue root].
OBJECTIVE
To investigate the surgical technique which could preserve the swallowing and laryngeal function effectively in the malignant head and neck tumors involving the tongue root.


METHODS
From January 2003 to December 2008, 31 cases of malignant head and neck tumors involving the tongue base had been treated in this hospital were retrospectively analyzed. There were 27 males and 4 females in which 9 cases of primary malignant tumor were from the base of tongue; 3 cases were from the tonsil, 11 cases were from supraglottic laryngeal carcinoma and 8 cases were from hypopharyngeal carcinoma. Preserved the lingual artery of the reserved side and the normal tissue of the root of tongue according to the clinical anatomy of lingual artery during the operation. If preoperative CT had indicated that bilateral lingual arteries were involved, total glossectomy should have been done. The epiglottis, vocal cords and the ventricular band of larynx was preserved as much as possible for the mechanisms of laryngeal function.


RESULTS
In this group, residual tongue necrosis did not occurred. One case with total glossectomy didn't remove the trachea cannula. Five had total laryngectomy. The other 25 cases decannulated from 14th days to 90th days postoperatively. The time of oral feeding was started from 10th days to 31st days postoperatively. Two cases with hypopharyngeal carcinoma developed fistula, which were cured by dressing change. Two with root of tongue cancer and 1 with tonsil cancer had postoperative infection and healed in 2 weeks. The median follow-up time was 36 months, and the Kaplan-Meier 3-years and 5-years survival rates were 79.5% and 69.6% respectively.


CONCLUSIONS
In the surgical treatments of the malignant head and neck tumors involving the base of tongue, the excisions and reconstructions of the primary tumor and the involved tongue base according to the clinical anatomy of lingual artery and the protection mechanisms of laryngeal function during the operation was one of the most effective technique to preserve the swallowing and laryngeal function.
Department of Otorhinolaryngology Head and Neck Surgery, First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
Yi
Y
Zhao
Ye-hai
YH
Liu
Jin-yu
JY
Mei
Di-hong
DH
Lu
Jing
J
Wu
Yun-xia
YX
Ma
Ke-lin
KL
Yang
D000328:Adult; D000368:Aged; D003679:Deglutition; D005260:Female; D005927:Glossectomy / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007830:Larynx / Q000502:physiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D014062:Tongue Neoplasms / Q000556:secondary / Q000601:surgery*