Per Oral Resection of Oral Tongue Squamous Cell Carcinoma

  • Krishnakumar Thankappan

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Surgery is the key modality in the management of oral cancer. Anterior two-third is the most common site of tongue cancer. Most malignancies occur on the lateral or the ventral surface of the tongue. Early stage tumors require single modality surgical treatment which includes wide resection of the tumor with adequate margins and a neck dissection. There are many approaches that aid in the surgical access of such cancers. Many tumors could be removed per orally without any added facial incisions. The present video demonstrates one such case, early T1 staged tumor. This video maximizes viewers’ insights through the surgical indications and the steps of the surgery.

Introduction

This surgical video presents two cases of management of oral tongue cancer, one of early T1 staged tumor and second of T3 staged tumor where these tumors are removed per orally. It takes the viewers through the indications, technique and surgical pearls.

About The Author

Krishnakumar Thankappan

Dr. Krishnakumar Thankappan is presently working as Professor, head and neck surgery and oncology, Amrita Institute of Medical Sciences, Kochi, Kerala, India. He is a teacher for MCI approved MCh program in head and neck surgery and oncology. His basic training is in otolaryngology from BJ Medical College, Pune. He completed MCh in head and neck surgical oncology from Amrita Institute of Medical Sciences, Kochi and an advanced fellowship in head and neck oncology from Roswell Park Cancer Institute, Buffalo, New York, USA. He also got trained in robotic head and neck surgery from South Korea and has taken initiatives to establish a Robotic Thyroidectomy program in India.

 

About this video

Author(s)
Krishnakumar Thankappan
DOI
https://doi.org/10.1007/978-981-15-6065-1
Online ISBN
978-981-15-6065-1
Total duration
9 min
Publisher
Springer, Singapore
Copyright information
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2020

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Video Transcript

[MUSIC PLAYING]

Hello, US. I’m Dr. Krishnakumar Thankappan, professor in head and next surgery and oncology, I’m with the Institute of Medical Sciences, Kochi, India.

This is a video on per-oral resection for carcinoma tongue. Anterior two thirds of the tongue is the most common site of tongue cancer. Most malignancies occur on the lateral border and ventral surface of the tongue. Surgery is the primary modality of treatment in oral squamous cell carcinoma.

Most early-stage lesions, including T1 and T2 tumors of the tongue, will require a single modality surgical treatment. This involves a wide resection of the tumor with adequate margins, neck dissection, and appropriate reconstruction. The surgical approaches could be a per-oral approach, a mandibulotomy approach, a lower cheek flap approach, a visor flap approach, or an upper cheek flap approach.

This video demonstrates the steps of a per-oral wide local excision of a T1 squamous cell carcinoma of the oral tongue in a 40-year-old lady. She presented with a minimally painful growth on the left lateral border of the tongue, more towards the tip, about 2 centimeters in dimension. The lesion had moderate thickness on pinching the lesion.

An ultrasound scan was done to assess the neck, and no significant nodes were visualized. In smaller lesions, a cross-sectional imaging, like CT scan or an MRI scan, may not be always required.