Speech, chewing and swallowing are elementary functions. Unfortunately, patients with tongue cancer who need to undergo extensive removal of the tongue, show a significant impairment of these functions, which significantly affects their quality of life. Innovative operations involving tissue transplantation, not from a foreign donor, but from the patient's own body (usually from the patient's forearm or thigh), ensure that patients will maintain the functions of speech and swallowing after a glossectomy.
Cancer of the tongue, as a rule, develops from squamous cells that cover the inside of the mouth and, by extension, the tongue (squamous cell carcinoma).
The exact cause of tongue cancer is not known. But it happens most often in people who smoke pipes, cigars, cigarettes and in people who chew tobacco. It is also more common in people who consume large amounts of alcohol and in patients who have dentures. It occurs mainly in men over 60 years of age, while it is rare in people younger than 40 and in women.
According to Cancer Research UK, the main symptoms of tongue cancer are:
- Red or whitish plaque, like a spot, that persists for weeks or months
- Ulcer or swelling of the tongue (fig. 1)
- Pain during swallowing
- Dyskinesia of the tongue with difficulty speaking and swallowing
- Unexplained bleeding of the tongue not due to injury
- Pain in the ear (less common)
It should be noted that these symptoms may be due to another, less serious condition and therefore an examination by a qualified doctor is necessary.
Surgical treatment is a cornerstone in the treatment of tongue cancer. When it comes to small carcinomas, a small removal of part of the tongue does not lead to a significant reduction in its functionality. However, in cases where half or more of the tongue has to be removed, failure to reconstruct this part of the tongue will result in a significant reduction in the patient's ability to speak and swallow.
The most modern way of reconstructing the tongue is the free transplantation of autologous tissue from the patient using microsurgical techniques. With this method, a graft is taken from the patient's thigh or forearm (Fig. 2) along with vessels that supply blood to the graft and then transplanted into the patient's tongue (Fig. 3). To do this, the plastic surgeon - microsurgeon must connect the vessels of the graft with the vessels in the patient's neck in order for the graft to be healed and come back to life. The joining of the vessels is done with the help of a microscope, as the vessels are so small (1-2 mm) that it is impossible to do it with the naked eye.
Konstantinos C. Vachceanos MD, DDS, PhD
Oral & Maxillofacial Surgeon
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