Abstract
Objectives: Total glossectomy is a morbid procedure offered to patients with advanced tumors of the oral cavity and oropharynx. Reconstruction of the resultant defect is typically performed immediately after resection, with regional and free tissue transfer being most commonly used. The goals of this study are to demonstrate: 1) long-term survival, 2) long-term swallowing outcomes, 3) rate of tracheostomy dependence, and 4) reconstructive techniques utilized after total glossectomy. Methods: Retrospective chart review of patients who received total glossectomy at Vanderbilt between 2000 and 2010. Survival and functional outcomes were followed from the day of the surgery to the last outpatient note. Results: 22 patients were included in this study, and 15 patients were alive 1 year post-surgery. Average length of survival after the operation was 715 days. 4 patients received concomitant total laryngectomy. 14 of 18 patients that received tracheostomy were able to be decannulated, with an average time to decannulation of 23 days. 6 of the 22 patients were able to maintain 100% of their nutrition with PO feedings at 12 months post-surgery. Reconstructive methods included 8 anterolateral thigh free flaps, 4 pectoralis flaps, 4 radial forearm free flaps, 2 scapular free flaps, 1 latissimus free flap, 2 lateral arm free flaps, and 1 jejunal free flap. Conclusions: Total glossectomy can significantly extend the lives of patients with advanced tongue cancer. However, this operation carries significant morbidity in regards to swallowing, and potentially the need for long-term tracheostomy.
Published Version
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