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Purpose: To define factors influencing postoperative aspiration in tongue cancer patients and to analyze the characteristics of dysphagia before and after surgery., Materials and Methods: A total of 112 tongue cancer patients participated in this work. Videofluoroscopic swallowing studies were performed in all patients before and after surgery. A Penetration-Aspiration Scale score of 3 or greater was defined as an aspiration risk. Qualitative data were collected on a frame-by-frame basis from each videofluoroscopic swallowing study and analyzed., Results: Smoking (58.14%, P < .01), tongue resection greater than 50% (38.71%, P < .05), and advanced tumor stage (49.18%, P < .01) were strong risk factors for aspiration. High incidences of inadequate tongue movement, delayed oral transit time, reduced hyoid bone elevation, poor aspiration or penetration, vallecula epiglottica, and residual material in the pyriform sinuses were evident after surgery (all P < .001). The Penetration-Aspiration Scale score was significantly higher after surgery than before surgery. The incidence of silent aspiration increased to 6.25% postoperatively., Conclusions: Smoking, larger tongue resection, and advanced tumor stage were strong risk factors for postoperative aspiration and dysphagia complications in tongue cancer patients. The aspiration rate was higher after surgery. Further studies should focus on the prevention and early treatment of dysphagia, especially postoperative aspiration, in tongue cancer patients., (Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Background: The purpose of this study was to evaluate tongue function in patients with tongue cancer after reconstruction with innervated supraclavicular fasciocutaneous island flaps (iSFIFs) with the cervical plexus (iSFIFs-SPN) or reinnervated SFIFs with neurorrhaphy of the cervical plexus and lingual nerve (rSFIFs-SPN-LN)., Methods: Forty-two tongue defects were reconstructed using iSFIFs-SPN and rSFIFs-SPN-LN. Two-point discrimination tests revealed a significant difference on the dorsal and ventral hemitongue reconstructed using rSFIFs-SPN-LN from control values., Results: No statistical difference in swallowing, speech, or esthetic outcome was found in the iSFIFs-SPN or the rSFIFs-SPN-LN. A significant difference was noted in the dorsal aspect and ventral surface of hemitongues reconstructed with rSFIFs-SPN-LN from control values and between 6 and 12 months., Conclusion: Sensation after hemitongue reconstruction with the iSFIF-SPN and the neurorrhaphy of the cervical plexus nerve was sutured to the lingual nerve, sensation after hemitongue reconstruction with the rSFIF-SPN-LN approached normal 6 to12 months postoperatively., (Copyright © 2013 Wiley Periodicals, Inc.)

Objective: To assess the reliability and usefulness of the extended supraclavicular fasciocutaneous island flap (eSIF) for reconstructing soft tissue defects followinng tongue cancer ablation., Methods: Twenty-two tongue defects in 22 patients with tongue cancer were repaired with eSIF after resection of the tongue malignant tumours. The sizes of the skin paddle ranged from (4 cm × 6 cm) to (8 cm × 14 cm) (average: 5.5 cm × 8.7 cm)., Results: The eSIF survived in twenty cases, including two cases with minimal partial necrosis. The patients were follwed up for 5 - 16 months. Eighteen patients were alive with disease free, two were alive with disease and two died of a lung and liver metastasis., Conclusions: The eSIF is reliable for reconstructing oral defects following the ablation of advanced oral malignant tumors.

Purpose: To study the changes and factors affecting the quality of life (QOL) of patients with tongue cancer 1 year after primary surgery., Patients and Methods: A total of 289 consecutive patients with tongue cancer who had undergone primary surgery from 2003 to 2008 at our hospital were recruited. Patient QOL was evaluated using the University of Washington Quality of Life Questionnaire, version 4. Statistical analysis was conducted using a paired-samples t test and multiple stepwise linear regression with Statistical Package for Social Sciences, version 11.5 (SPSS, Chicago, IL)., Results: At 1 year after surgery, the appearance, activity, speech, swallowing, shoulder function, salivary, and taste domain scores were significantly lower than the preoperative scores (P < .05). However, the pain, anxiety, and mood scores were significantly better 1 year after surgery (P < .05). The overall QOL had increased greatly 1 year after surgery but did not reach the pretreatment level. Multiple stepwise linear regression analysis showed that the main factors affecting QOL were radiotherapy, advanced clinical stage (P < .05), socioeconomic status, and patient age. Radiotherapy, advanced clinical stage (P < .05), socioeconomic status, and age (P < .05) were independently associated with QOL., Conclusions: The patients with tongue cancer who have been diagnosed and treated early might have a better QOL. A greater socioeconomic status can also improve the QOL of patients with tongue cancer after primary surgery., (Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Objective: To assess the reliability of the facial-submental artery island flap for reconstructing tongue defects and the aesthetic benefits of using two V-Y islanded flaps for repairing the resulting submental defect., Study Design: Case series with chart review., Setting: Patient with tongue cancer, younger patient, cosmetic outcome., Subjects and Methods: Thirty-three tongue defects were repaired with facial-submental artery island flaps, and the submental defects were repaired with two V-Y advancement flaps. The ages of the patients ranged from 28 to 57 years; 19 were men and 14 were women. All of the lesions were tongue squamous cell carcinoma. The size of the facial-submental artery island flap ranged from 3.5x7.0 to 5.0x8.0 cm. The size of the V-Y advancement flaps ranged from 3.0x3.0 to 4.0x4.0 cm. Direct closure was achieved at all donor sites., Results: The facial-submental artery island flaps and V-Y advancement flaps survived in 93.9 percent and 97.0 percent, respectively. The patients were followed for 12 to 26 months. The functional results in terms of speech and swallowing were good, and the aesthetic outcomes using two V-Y advancement flaps to repair the submental defects were satisfactory. Two patients with extracapsular lymph node spread developed local recurrence: One is alive with disease and the other is dead., Conclusions: The facial-submental artery island flap is a simple, reliable flap that is preferred for reconstructing tongue defects. Using two V-Y advancement flaps for repairing the donor site defect improves the cosmetic outcome in the submental region.

In this study we explored an effective method to repair defects in the tongue that had been produced during removal of advanced tongue cancer. Eighteen patients with advanced squamous cell carcinoma of the tongue were treated, and extended vertical lower trapezius island myocutaneous flaps based on the transverse cervical artery were used to repair more than half the tongue. No flap failed completely and no shoulder was affected. The lingual contours were excellent. The functional results in terms of speech and swallowing were satisfactory. The patients were followed up for 6 to 24 months. Three of them were alive with disease and two have died of the local recurrence or metastasis at 18 and 20 months, respectively. The extended vertical lower trapezius island myocutaneous flap is a large, simple, and reliable flap, which is preferred for reconstruction of defects of the tongue after removal of advanced tongue cancer.

Objective: To evaluate the oncologic efficacy, surgical safety, postoperative beauty, and morbidity of an ideal procedure of modified radical surgery in tongue cancer at early stages., Methods: Six patients with early stage squamous cell carcinoma of tongue underwent a procedure of modified radical surgery, in which an inconspicuous incision was used, the external jugular vein, sternocleidomastoid muscle, spino-accessory nerve, and greater auricular nerve were preserved, half of glosso and mouth floor were excised, and the defect was repaired instantly. Recurrence of glosso, mouth floor and neck, regional edema, shoulder dysfunction, auricle sensibility, oral cavity function and beautiful outlook on the face and neck were evaluated clinically., Results: Compared with classic radical neck dissection, this procedure of modified radical surgery showed an inconspicuous incision and pretty appearance, minor edema on face and neck, better shoulder function, and sensation of auricular skin. No recurred to the glosso, mouth floor, and neck was found during follow-up. The patients showed better oncological safety, pretty appearance of tongue, and better oral function of speech, swallow and mastication., Conclusion: This ideal procedure of modified radical surgery in tongue cancer at early stages lessens or avoids destruction of face and neck, shoulder malfunction, numbness of auricular skin, and oral dysfunction of speech, swallow and mastication without impairment on the oncologic safety of the radical surgery, and improves the quality of life of the patients.

Objective: To explore the clinical value and safety of using rib-major pectoralis myocutaneous flap carrying costal parietal pleura in combined repair of large soft and hard tissue defect caused by radical surgery of advanced tongue cancer., Methods: Six patients with advanced tongue carcinoma involving the floor of mouth and mandible were performed combined radical neck dissection with glossectomy and mandibulectomy, which caused large soft and hard tissue defect. Six rib-major pectoralis myocutaneous flaps carrying costal parietal pleura were transferred for immediate repair of the large defects. The rib flaps were applied for the repair of mandible, and the major pectoralis myocutaneous flaps were applied for the reconstruction of tongue and floor of mouth., Results: Six patients recovered well after operation. Six rib-major pectoralis myocutaneous flaps carrying costal parietal pleura survived well; the wounds of surgical incision of the oral cavity, neck, and chest healed up. The reconstructed tongue and the lower face appearance were satisfactory, the occlusion relationships were normal; the speaking as well as swallowing functions recovered., Conclusions: It's safe and reliable to use rib-major pectoralis myocutaneous flap carrying costal parietal pleura to repair large soft and hard tissue defect in oral and maxillofacial region. Opening pleural cavity and harvest costal parietal pleura would not influence patients' thoracic movement and breath function and would not cause other complications. It's simple and safe for harvesting the composite flap. Carrying costal parietal pleura assures the sufficient blood supply of rib in the composite flap.

Background & Objective: Radical operation of tongue carcinoma causes hemi-tongue defective, which seriously affected the quality of life in these patients. The primary tongue reconstruction guaranteed the healing of the surgical incision at early stage. This may help to recover swallowing and speaking of the patients. However, the vascular crisis happened in the free flap proved to be an obstacle to the extensive application in the tongue reconstruction. This paper illustrated some modifications in the application of the free forearm flap, which may ensure the success in operation., Methods: Some methods like skin flap design, preparation and vascular anastomosis were modified in the application among the 32 tongue carcinoma patients., Results: The surgical incisions of the oral cavity and neck healed up, with no salivary fistula, chylorrhea, submandibular fistula, infection and other complications. After the operations, 6 flaps developed vascular crisis, and 5 flaps were successfully salvaged, meanwhile, one case failed, which resulted in the flap abandonment. The total successful transplantation rate reached 96.9%. The reconstructed tongue recovered, and the speaking as well as swallowing functions re-obtained., Conclusion: The modified methods of tongue reconstruction with free forearm flap improve the clinical effects of reconstructed tongue.