Oral Cavity Carcinoma Research Articles

Pioneering Clinical Investigation: Beta Defensin Expression in Patients of Squamous Cell Carcinoma of Oral Cavity as a Forward-Looking Validation for Molecular Treatment

Pioneering Clinical Investigation: Beta Defensin Expression in Patients of Squamous Cell Carcinoma of Oral Cavity as a Forward-Looking Validation for Molecular Treatment

Pattern of Recurrence and Metastatic Disease in Post Operative Postradiotherapy Patients of Squamous Cell Carcinoma of Oral Cavity

Objective: Oral cavity is one of the common site of cancer in head and neck. They have high cure rate but locoregional failure seen in some cases at primary, nodal or metastatic site. We retrospectively analysed treatment results of oral cavity cancer in our institute and intented to define the prevalence and pattern of failure. Materials and Methods: It is a prospective cohort study. 179 cases of post operative oral cavity cancer between January 2019 to December 2021, who took radiotherapy or chemoradiotherapy treatment in our institute were studied. 79 patients had loss of follow up during and after treatment. Results of study excluded these patients. Results: Median follow up was 24 months (8-40 months). Treatment failure after radiotherapy or chemoradiotherapy at primary site and at nodal site was 22 % and 2 % respectively. In 8% cases recurrence was present at both primary and nodal site. Metastasis at extra nodal site occurred in 4% cases (3% in liver, 1% in bone). Conclusion: Operated case of oral cavity cancer when treated with radiotherapy or chemoradiotherapy has very high cure rate and few locoregional failures at primary and nodal site and rarely at distant site. Recurrence most commonly seen in advanced disease. Therefore, advanced disease patients should be treated with more aggressive treatment to achieve higher cure rate in oral cavity cancer patients. Disease free survival and overall survival was better in early stage than in advanced stage. Node positive disease had more risk of recurrence and metastasis.

Impact of Cancer Localization on Symptom Burden and Quality of Life in Head and Neck Cancers: A Comparative Study.

Background: Head and neck cancer (HNC) is a critical concern in oncology, with notable disparities in survival rates. While the long-term symptom burden in HNC survivors and its impact on quality of life (QoL) has been explored, there is limited understanding of the influence of cancer localizations on these aspects. This study aims to elucidate the role of cancer localizations in shaping long-term outcomes in HNC patients. Methods: A cross-sectional study was conducted at the University Hospital Erlangen's Department of Otolaryngology, exploring the impact of cancer localization on symptom burden and QoL in 138 HNC patients using the University of Washington Quality of Life Questionnaire Version 4. Results: In our study of HNC patients, we investigated symptom burden across different cancer localizations, including oral cavity, oropharyngeal, hypopharyngeal, laryngeal, and cancer of unknown primary (CUP). While we found no significant variations in parameters such as pain, appearance, and activity, notable differences emerged in swallowing, speech, and salivation. Patients with oral cavity and laryngeal carcinomas had significantly higher swallowing and salivation scores compared to those with oropharyngeal carcinoma and CUP, while speech-related symptoms were lower for oral cavity and laryngeal carcinoma patients. Importantly, these symptom differences did not significantly impact health-related and overall QoL. These findings emphasize the nuanced interplay between symptomatology and QoL in different HNC cancer localizations. Conclusion: The research highlights significant disparities in post-treatment symptoms across different HNC localizations and underscores the need for personalized treatment and management strategies to address unique challenges associated with each HNC type, ultimately aiming to enhance post-treatment QoL.

An Integrated Approach of Network Pharmacology, Bioinformatics, Molecular Docking, and Experimental Verification Uncovers Prunellae Spica as the potential Medicine of Prognosis Improvement for Oral Squamous Cell Carcinoma.

Prunellae Spica (PS), the spike from Prunella vulgaris L., is a traditional Chinese medicine that can treat Oral Squamous Cell Carcinoma (OSCC), whereas its molecular mechanisms and effects on the prognosis of patients remain unclear. Our study aimed to identify potential anti-OSCC targets of PS and explore its mechanisms and effects on prognosis through network pharmacology, bioinformatics analysis, molecular docking, and in vitro cell assays. Sixty-two potential targets of 11 active anti-OSCC ingredients of PS were identified, with Quercetin, the core ingredient of PS, exhibiting the most significant number of OSCC-related targets. GO analysis indicated that the primary biological processes involved in OSCC treatment by PS were the cellular response to nitrogen compound, response to xenobiotic stimulus, and cellular response to organonitrogen compound. KEGG analysis revealed that Pathways in cancer were the top highly enriched signaling pathway in the treatment of OSCC by PS. DisGeNET analysis is mainly about Lip and Oral Cavity Carcinoma. More importantly, 6 of the 62 targets were markedly related to prognosis. Molecular docking revealed high affinities between the key component and the prognosis-related target proteins. Treatment of OSCC cell line SCC-25 with Quercetin could inhibit malignant biological behaviors, such as cell proliferation, colony formation, invasion, and migration, as well as affect the targets related to prognosis and promote autophagy. Overall, these results suggest that PS plays a significant role in treating and improving the prognosis of OSCC by directly influencing various processes in OSCC.

1132: Adjuvant Intensity Modulated Radiation Therapy in Oral Cavity Carcinomas with Pedicled Flap

1132: Adjuvant Intensity Modulated Radiation Therapy in Oral Cavity Carcinomas with Pedicled Flap

Re-classifying cT4b buccal mucosa / Gingivo-buccal complex cancers: Do we need to change?

IntroductionT4b carcinoma are termed as very locally advanced carcinoma of oral cavity. These tumors are deemed borderline resectable or unresectable. Role of surgery for these group of patients is not very well defined. We aimed to relook role of surgery for cT4b carcinoma oral cavity. Material and methodsWe evaluated 596 patients of cT4 oral cancers. Two hundred eighteen patients were stagged as cT4b based on clinico- radiological findings. These patients underwent bite composite resection either upfront or post neoadjuvant chemotherapy. Additional compartmental infratemporal fossa clearance was done for patients with involvement of more than 2 of following structures: medial and lateral pterygoid muscles, pterygoid plates, temporalis at tip of coronoid process, high masseter involvement and retroantral fat pad involvement. Oncological outcomes and prognostic factors were estimated. ResultsPatients were treated between Aug 2013 to May 2021. Compartmental ITF clearance was done for 93 patients and rest had standard surgical clearance. One hundred and twelve patients had node positive disease. The median age of group was 50 years (Range= 24 to 84 years). On a median follow up of 54 months (IQR = 1-111 months), 136 (62.4%) were alive and 82 (37.6%) patients died. Five year Loco-regional control, disease free survival and overall survival was 54%, 52% and 59% respectively. On multivariate analysis, presence of nodal disease, perineural invasion and bone involvement were significant factors affecting overall survival. ConclusionSurgery for cT4b oral cancer is feasible and associated with acceptable oncological outcomes.

Local Flap Reconstructions in Oral Cavity Defects: An Insight from 104 Cases.

Resection of oral cavity carcinoma often leads to complex defects causing functional and aesthetic morbidity. Providing optimum reconstruction with free flaps becomes challenging in a high-volume center setting with constrained resources. Hence, understanding the local flap technique for reconstructing oral cancer defects is prudent. This study is a retrospective analysis of prospectively operated cases of oral cavity resections which were subsequently reconstructed using local flaps from 2019 to 2022. Patients who underwent reconstruction with either melolabial flap, islanded facial artery myomucosal (FAMM) flap, submental flap, supraclavicular artery island flap, infrahyoid flap, or platysma myocutaneous flap (PMF) were included in this analysis. Eligible patients were followed up to evaluate functional outcomes like oral feeding and to analyze the Performance Status Scale for Head and Neck Cancer. The study included 104 patients. The tongue was the most common subsite, resulting in most hemiglossectomy defects, which were reconstructed using the melolabial flap procedure. Buccal mucosa defects in our series were reconstructed using the supraclavicular flap, whereas the submental flap procedure was the choice for lower lip-commissure defects. Complications such as partial and total flap loss, deep neck infection, and donor site complications like infection and gaping, oral cutaneous fistula, parotid fistula, and seroma were analyzed; the supraclavicular flap presented with a majority of complications. Local flaps are an alternative to free flap reconstruction in select cases with optimum functional outcomes and minimal donor site morbidity. This article comprehensively reviews the surgical steps for various local flap procedures in oral cancer defects.

Assessment of Pattern of Cervical Lymph Node Metastasis in Squamous Cell Carcinoma of Oral Cavity

Objective: Cervical lymph node involvement is crucial for prognostic factor for oral squamous cell carcinomas, and understanding nodal metastasis pattern is essential for optimal neck dissection, oncological control, and minimizing morbidity. This study reviews nodal involvement and skip metastasis in 316 oral SCC patients to determine the extent of neck dissection. Methods: The retrospective study analysed 316 patients with oral cancer diagnosed between 2017 and 2020, including those with primary oral cavity cancer who underwent neck dissection. A comprehensive assessment of patient data was used to determine the extent and size of the lesion and lymph node involvement. Preoperative staging was confirmed using various imaging techniques, including OPG, CT MRI, and biopsies. Histological examination results were used to categorize carcinomas based on differentiation levels and to identify nodal involvement patterns. Results: The most common subsite for 316 patients was the tongue (62%), followed by the buccal mucosa (19%), lower alveolus (10.2%), hard palate (3.2%), retro molar trigone (2.8%), floor of the mouth (1.6%), upper alveolus (0.9%), and lower lip (0.3%). Nodal metastasis were more common in Levels II and Ib, with less involvement in Level III and beyond. Tumour with a DOI greater than 10 mm showed higher nodal metastasis frequency, with an increased occurrence in Levels IA, IB, II, III, and IV. Conclusion: Nodal metastasis in oral cancer are common in Levels II and Ib, with variations based on subsite. Alveolus and buccal mucosa malignancies involve fewer lymph nodes beyond Level III, while tongue malignancies show greater involvement in lower levels Level IV involvement is more frequent with greater DOI, and skip metastasis are rare.

Frequency and involvement of lymph nodes in squamous cell carcinoma of oral cavity in cross sectional population.

Objective: To find out the frequent site of squamous cell carcinoma of oral cavity and pattern of neck node involvement in cross sectional population. Study Design: Prospective Study. Setting: Department of Otorhinolaryngology Head and Neck Surgery, Abbasi Shaheed Hospital Karachi and Karachi Medical and Dental College. Period: 01-06-2023 to 31-12-2023. Methods: Patients who biopsy proven squamous cell carcinoma of oral cavity visited ENT department Abbasi Shaheed Hospital were include in this study. Proforma was made in which detail history and examination were noted. Oral cavity examined to see the size and site of tumor. Neck was palpated to see palpable cervical lymph node. CT scan head and neck with contrast was done. Those patients who fulfilled the inclusion and exclusion criteria included in this. Result: 56 patients were selected in this study who fulfill the inclusion criteria. Male were 37 (66%). Maximum number of patients were between the 41-50 years of age, 24 patients (42.8%). Most common site of carcinoma was buccal mucosa 27 (48.2%). Highest number of patients presented with T3 stage 22 patients (39.2%). The frequency of lymph node involvement noted in 35 (62.5%) patients while 21 (37.5%) came with no lymph node. Level I was the most frequent level involved, it was involved in 28 patients (50%). Conclusion: Oral squamous cell carcinoma usually reported late. Early referral to otorhinolaryngologist and educate patient to consult Otorhinolaryngologist as earliest for early diagnosis and appropriate treatment plan.

Large cell neuroendocrine carcinoma of oral cavity: A rare case report with review of literature

Abstract Neuroendocrine tumours (NETs) primarily affect the lungs and larynx. Primary neuroendocrine carcinomas (NECs) rarely occur in the oral cavity. The classification of these tumours is ambiguous; however, the literature acknowledges their aggressiveness. Merkel cell carcinoma (MCC) is rare and more common in the skin but could occur intraorally. MCC and NECs are aggressive neoplasms and recommend intensive treatment. In this case report, a 22-year-old female presented with an ulceroinfiltrative lesion in the left buccal mucosa of the cheek, which was diagnosed as primary NEC in the oral cavity. This patient underwent wide local lesion excision of oral cavity mass, ipsilateral selective neck node dissection of levels 1–4 and postoperative chemotherapy. This aggressive tumour type requires large local excisions with margins like Merkel cell skin carcinomas. To our knowledge, this is the youngest oral cavity primary neuroendocrine cancer patient to date in the literature.

Turbocharging of Deep to Superficial Venous System for Vessel Depleted Neck in Radial Forearm Free Flap: A Case Report of One Neck Vein for Drainage of Both Venous Systems

Dual venous anastomosis in radial forearm free flap surgery increases chances of flap survival as compared to anastomosing only the superficial system. A 48-year-old male patient who had received three previous microsurgical reconstructions and radiotherapy presented with recurrent oral cavity carcinoma. Two of these reconstructions were anastomosed to the left side neck vessels. The recurrence was in the left half of the soft palate. The left neck and underlying vessels were severely scarred and fibrotic, and only 2 cm of the left internal jugular vein (IJV) could be circumferentially mobilized for anastomosis, allowing for only one venous anastomosis. The radial forearm free flap was harvested and a tributary of the cephalic vein was preserved in the proximal part to act as a conduit for drainage of one of the venae comitantes. The cephalic vein was anastomosed end-to-side to the IJV and one venae comitantes to the preserved tributary in end-to-end fashion. The flap survived and the patient was discharged in a week. This novel method helps to drain both venous systems through one available neck vein.

Clinical Implications of EMT in HNSCC: A Review of the Factors and Pathways at Play

_Background: _Epithelial-mesenchymal transition (EMT) is a biological process where epithelial cells acquire mesenchymal traits. Epithelial cells are characterized by tight cell-cell adhesions and apical-basal polarity, whereas mesenchymal cells are generally elongated in appearance with loose cell-cell interactions, allowing increased cell migration. Many studies have been done on EMT pathways in oral cavity carcinoma, but there are few studies about the possible clinical implications. _Aims_ _&_ _Objectives:_ This systematic review was carried out to find the clinical implications of EMT in HNSCC and bring together the molecular, genetic, and epigenetic pathways found to be acting on the cadherin switch. _Materials & Methods: _An extensive search for relevant papers was made on PubMed, Medline, and Google Search. Only good-quality studies pertaining to epithelial–mesenchymal transition in oral cavity cancers in humans were selected. Furthermore, all selected papers were assessed for their clinical relevance. _Results: EMT has role in prognostication, diagnostic dilemma, margin assessment, mandibular preservation, making OSCC more prone to systemic therapies and planning risk reduction in strategies. _The cadherin switch is regulated by transcription factors like Snail, SLUG, ZEB1, and ZEB2. It is also acted on by epigenetic modifiers. These transcription factors are regulated by multiple pathways like Wnt/β–catenin, PI3K/AKT, MAPK, etc. These pathways are in turn regulated by molecular and external agents like NNK from tobacco smoke, hypoxia, the DDB2 gene, reactive oxygen species (ROS), and melatonin.

Tumor-stroma contact ratio - a novel predictive factor for tumor response to chemoradiotherapy in locally advanced oropharyngeal cancer

The growth pattern of oropharyngeal squamous cell carcinomas (OPSCC) varies from compact tumor cell aggregates to diffusely infiltrating tumor cell-clusters. The influence of the growth pattern on local tumor control and survival has been studied mainly for surgically treated oral cavity carcinomas on a visual basis. In this study, we used multiplex immunofluorescence staining (mIF) to examine the antigens pan-cytokeratin, p16INK4a, Ki67, CD271, PD-L1, and CD8 in pretherapeutic biopsies from 86 OPSCC. We introduce Tumor-stroma contact ratio (TSC), a novel parameter, to quantify the relationship between tumor cells in contact with the stromal surface and the total number of epithelial tumor cells. mIF tumor cores were analyzed at the single-cell level, and tumor-stromal contact area was quantified using the R package "Spatstat". TSC was correlated with the visually assessed invasion pattern by two independent investigators. Furthermore, TSC was analyzed in relation to clinical parameters and patient survival data to evaluate its potential prognostic significance.Higher TSC correlated with poor response to (chemo-)radiotherapy (r = 0.3, p < 0.01), and shorter overall (OS) and progression-free (PFS) survival (median OS: 13 vs 136 months, p < 0.0001; median PFS: 5 vs 85 months, p < 0.0001). Visual categorization of growth pattern according to established criteria of tumor aggressiveness showed interobserver variability increasing with more nuanced categories (2 categories: k = 0.7, 95 %-CI: 0.55 - 0.85; 4 categories k = 0.48, 95 %-CI: 0.35 - 0.61).In conclusion, TSC is an objective and reproducible computer-based parameter to quantify tumor-stroma contact area. We demonstrate its relevance for the response of oropharyngeal carcinomas to primary (chemo-)radiotherapy.

Photodynamic therapy in treatment of squamous cell carcinoma of oral cavity with chlorine e6 photosensitizer with long-term follow up

Photodynamic therapy is an effective method for treating superficial forms of malignant neoplasms, characterized by a minimal risk of damage to normal tissues. In this study, we presented our experience of treating cancer of the oral mucosa using photodynamic therapy, and analyzed the immediate and long-term results of treatment. 38 patients with squamous cell carcinoma of oral cavity mucosa, with a depth of invasion no more than 7 mm, were included in the study. All patients underwent photodynamic therapy with chlorine e6 based photosensitizer. Photosensitizers were administered intravenously 3 hours before irradiation, at a dosage of 1 mg/kg of the patient’s weight. Photodynamic therapy was performed with the following parameters: P – 1.0 W, Ps – 0.31 W/cm2, E – 300 J/cm2. The area of one irradiation field ranged 1.0-2.0 cm2. Treatment effect was evaluated by RECIST 1.1. Overall survival, cancer-specific survival, and disease-free survival were calculated using Kaplan-Meier curves. Evaluation of adverse events was made by .TCAE 5.0 criteria. At 35 (92.1%) out of 38 cases, complete regression was observed after photodynamic therapy. Among them in 3 out of 35 patients relapse was diagnosed in 11.5 to 43.2 months. The total number of patients who didn’t respond to treatment was 6 (15.8%). Follow-up period was 4.2-87.3 months. (mean 42.9). 34 (89.5%) out of 38 patients are alive, 1 (2.6%) died from progression, and three died from other causes. The 5-year overall survival rate was 82.1%, cancer-specific survival rate was 97.0%, and disease-free survival rate was 81.1%. Among the factors significantly (p &lt; 0.05) influencing relapse-free survival: depth of invasion &lt; 5 mm (p – 0.013) and the presence of leukoplakia (p – 0.007). When assessing cancer-specific survival, factors worsening the prognosis were: age &gt;70 years (p – 0.034) and the presence of leukoplakia (p – 0.007). Photodynamic therapy is an alternative treatment method of oral cancer superficial lesions, in case of proper assessment of primary lesion and in case of possibility of full irradiation of the tumor. Moreover, after using photodynamic therapy, the underlying connective-muscular structures are preserved, which promotes rapid healing with minimal scarring, the functions of the affected organ remain intact, and cosmetic defects do not form.

What is the Optimal Method for Margin Assessment in Oral Cavity Carcinoma?

What is the Optimal Method for Margin Assessment in Oral Cavity Carcinoma?

Oral and oropharyngeal malignant minor salivary gland tumors: A retrospective study

IntroductionTumors of minor salivary gland origin are uncommon lesions, representing 2–3 % of all malignant neoplasms of the upper aerodigestive tract and 9–23 % of all salivary gland tumors.The aim of this study is to report the demographic features, sites, histological types and the management and outcomes of oral and oropharyngeal minor salivary gland tumors diagnosed and treated in a University Hospital with a multidisciplinary head and neck team. Materials and methodsA single-center retrospective observational study was conducted in a cohort of patients who received diagnosis of minor salivary gland carcinoma of oropharynx and oral cavity between July 30th 2000 and 30th September 2021. The following data of the included patients were collected: age, gender, smoke history, alcohol consumption, past medical history, comorbidities, anatomic location of the tumor, histopathology, staging, management, and outcomes. ResultsA total of 30 cases (16 females, 14 males) of oral and oropharyngeal minor salivary gland tumors were reviewed. The most frequent histotype was polymorphous adenocarcinoma (12 patients). The majority of patients presented with low stage at diagnosis, with 66,66 % of the population classified as stage I or II at diagnosis. On the whole, 29 patients out of 30 benefitted from a surgical approach as first treatment. In 11 patients, adjuvant radiotherapy was performed and in 6 cases it was associated with chemotherapy. Brachytherapy with different timing was performed in 5 cases. The recurrence rate was 26.66 %. Overall disease specific survival at five and ten years was found to be approximately 81 % and 33 % respectively. ConclusionsSurgery is still considered to be the gold standard of the treatment of minor salivary gland tumors. Radiation therapy, in spite of not being considered as a curative primary treatment for salivary malignancies, is extensively used as an adjuvant treatment.

Primary Management of Operable Locally Advanced Oral Cavity Squamous Cell Carcinoma: Current Concepts and Strategies.

Locally advanced oral cavity carcinoma (LAOCSCC) is primarily treated with surgery followed by radiotherapy with or without chemotherapy. A review of literature using PubMED was performed for studies reporting the management of LAOCSCC. Based on the reviewed literature and opinions of experts in the field, recommendations were made. Studies have shown that outcomes following resection of T4a and infranotch (inferior to mandibular notch) T4b are comparable. We discuss the concept of compartmental resection of LAOCSCC and issues concerning the management of the neck. Further, patients who refuse or are unable to undergo surgery can be treated with chemoradiotherapy with uncertain outcomes. The role of neoadjuvant chemotherapy has shown promise for organ (mandibular) preservation in a select subset of patients. The management strategy for LAOCSCC should be determined in a multidisciplinary setting with emphasis on tumor control, functional preservation, and quality of life of the patient.

Prevalence of Human Papillomavirus in Laryngeal, Oropharyngeal and Oral Cavity Carcinomas in Zadar County, Croatia

We present a retrospective research of HPV testing of tissue samples, by the polymerase chain reaction method (PCR), in patients that underwent surgery due to squamous cell carcinoma of the oral cavity, oropharynx or larynx in Zadar General Hospital in the period from 2007 to 2016.Out of 99 patients included in this study, 89 (89,9%) were men with median age of 62.3 years and ten (10,1 %) were women with median age of 66 years. According to the cancer site, the percentage of HPV positive carcinoma tissue samples of larynx carcinoma, oral cavity carcinoma and oropharyngeal carcinoma were 25.8%, 26.9% and 18,2 %, respectively. According to the HPV genotype, among all cancer sites, in 60% (n=15) HPV 16 were detected, and in 40% mixed HPV infection, that is, in 32% (n=8) HPV 16, 26, 34, 53 and in 8% (n=2) HPV 16, 18, 26, 34, 53.The presented research results support the need for stronger public health promotion of vaccines against HPV, and the selection of the best strategy for the implementation of vaccination to prevent cancer of the larynx, oropharynx and oral cavity among men.

A Quantitative Assessment of Apoptotic Index with Varying Histological Degree of Dysplasia and Squamous Cell Carcinoma of Oral Cavity - A Light Microscopic Study.

The aim of the present study was to quantitatively assess the apoptotic index at a light microscopic level in hyperkeratosis with varying histological degrees of dysplasia and different grades of oral squamous cell carcinoma (OSCC) and its correlation with prognostic significance. The study included the histo-pathologically diagnosed cases of hyperkeratosis with varying degrees of dysplasia and different grades of OSCC, which were retrieved from the archives of the department, and clinical details were retrieved from the case records of the patients. The sample size consisted of 80 biopsied cases, divided into seven groups of 10 experimental cases and one group of 10 cases of normal mucosa as a control group. The age range of 50-59 shows maximum patients of hyperkeratosis with varying degrees of dysplasia and OSCC. Maximum apoptotic bodies were seen in cases of severe dysplasia and well-differentiated cases of OSCC. There was an observational difference noticed in apoptotic bodies between the patients who had less than 1-year disease-free survival rate. The apoptotic cells are being seen using routine light microscopy techniques with hematoxylin and eosin staining. In different grades of squamous cell carcinoma, a decrease in the apoptotic count was noticed from well-differentiated squamous cell carcinoma toward poorly differentiated squamous cell carcinoma cases. Increased mean apoptotic bodies were observed in patients showing less than 1 year of survival.

Telemedicine-enabled biofeedback electropalatography rehabilitation (TEBER): A pilot study for patients treated with surgery for oral cavity carcinoma.

To address the rehabilitative barriers to frequency and precision of care, we conducted a pilot study of a biofeedback electropalatography (EPG) device paired with telemedicine for patients who underwent primary surgery +/- adjuvant radiation for oral cavity carcinoma. We hypothesized that lingual optimization followed by telemedicine-enabled biofeedback electropalatography rehabilitation (TEBER) would further improve speech and swallowing outcomes after "standard-of-care" SOC rehabilitation. Pilot prospective 8-week (TEBER) program following 8 weeks of (SOC) rehabilitation. Twenty-seven patients were included and 11 completed the protocol. When examining the benefit of TEBER independent of standard of care, "range-of-liquids" improved by +0.36 [95% CI, 0.02-0.70, p = 0.05] and "range-of-solids" improved by +0.73 [95% CI, 0.12-1.34, p = 0.03]. There was a positive trend toward better oral cavity obliteration; residual volume decreased by -1.2 [95% CI, -2.45 to 0.053, p = 0.06], and "nutritional-mode" increased by +0.55 [95% CI, -0.15 to 1.24, p = 0.08]. This pilot suggests that TEBER bolsters oral rehabilitation after 8 weeks of SOC lingual range of motion.