The following is a summary of “Glossectomy for the treatment of oral cavity carcinoma: Quantitative, functional and patient-reported quality of life outcomes differ by four glossectomy defects,” published in the July 2023 issue of Oral Oncology by Chepeha et al.

Using functional metrics, the MD Anderson Dysphagia Index (MDADI), and speech intelligibility, the objective was to characterize four clinically distinct glossectomy defects to establish significant quantitative cut points. The population included 101 patients treated with surgery, adjuvant radiation according to NCCN guidelines, and ≥12 months of follow-up. The following categories of defects were compared: subtotal hemiglossectomy, hemiglossectomy, extended hemiglossectomy, and oral glossectomy. All results validated the four-defect model. Intergroup comparison of subtotal hemiglossectomy outcomes (p value): 

Tongue Protrusion <0.001,<0.001,<0.001; Elevation Open Mouth Premaxillary Contact Height, <0.001, <0.001, <0.001 Obliteration, <0.6,<0.001,<0.001; Normalcy of Diet, <0.3,<0.001,<0.001; Nutritional Mode, <0.9,<0.8,<0.001; Range of Liquids, <0.4,<0.016,<0.02; Range of Solids, <0.5,<0.004,<0.001; Eating in Public, <0.2,<0.002,<0.03; Understandability of Speech, <0.9,<0.001,<0.001 Tissue transplantation was performed on 51%, 93.9%, 100%, and 100% of patients in four defect groups. Radiation, 24%,67%,88%,80%. Between hemiglossectomy and extended hemiglossectomy, the defect extends into the contralateral floor of the mouth and the anterior tonsillar pillar; resection of these subunits restricts tongue mobility, influencing the functional outcome and MDADI. 

The defect extends to the tip of the tongue between extended hemiglossectomy and oral glossectomy and appears to impact functional outcomes and MDADI. Subtotal hemiglossectomy, hemiglossectomy, extended glossectomy, and oral glossectomy are associated with quantitative (elevation, protrusion, open mouth premaxillary contact, and obliteration), qualitative (speech and swallowing) and MDADI differences, indicating that these four ordinal defect groups are distinct.

Source: sciencedirect.com/science/article/abs/pii/S1368837523001276