Skip to main content

Advertisement

SpringerLink
Log in

A detailed anatomical assessment of the lateral tongue extrinsic musculature, and proximity to the tongue mucosal surface. Does this confirm the current TNM T4a muscular subclassification?

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Purpose

The current T4a subclassification of the TNM staging system for oral malignancies has been criticised as based almost exclusively on anatomical data. The aim of this study was to provide anatomical confirmation of the muscular constraints of T4a classification of oral tongue tumours.

Methods

A detailed anatomical study describing and measuring the adjacency of the named extrinsic tongue muscles to the lateral tongue surface was completed on the Visible Human Female (VHF). The distance of styloglossus and hyoglossus to the over lying mucosa were determined.

Results

The appearance, position, orientation and anatomical relationships of the lateral tongue extrinsic muscles, with comparison to their classical descriptions are described. The right VHF styloglossus was 1.3 mm (0.33–1.48) and left 2.91 mm (0.66–7.68) from the mucosal surface in the axial plane. The right VHF hyoglossus was 2.93 mm (1.48–4.96) and left 4.33 (1.68–8.71) from the mucosal surface in the axial line.

Conclusions

In the lateral tongue, styloglossus and hyoglossus are very superficial. The inclusion criteria of hyoglossus and styloglossus in the T4a staging does not appear justified based upon their anatomical position.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Sobin LH, Gospodarowicz MK, Wittekind CH, International Union against Cancer (2010) TNM classification of malignant tumours. Wiley-Blackwell Chichester, West Sussex

    Google Scholar 

  2. Piccirillo JF (1995) Purposes, problems, and proposals for progress in cancer staging. Arch Otolaryngol Head Neck Surg 121(2):145–149

    Article  PubMed  CAS  Google Scholar 

  3. Snyderman CH, Wagner RL (1995) Superiority of the T and N integer score (TANIS) staging system for squamous cell carcinoma of the oral cavity. Otolaryngol Head Neck Surg 112(6):691–694

    Article  PubMed  CAS  Google Scholar 

  4. Ambrosch P, Kron M, Freudenberg LS (1998) Clinical staging of oropharyngeal carcinoma: a critical evaluation of a new stage grouping proposal. Cancer 82(9):1613–1620

    Article  PubMed  CAS  Google Scholar 

  5. Takes RP, Rinaldo A, Silver CE, Piccirillo JF et al (2010) Future of the TNM classification and staging system in head and neck cancer. Head Neck 32(12):1693–1711

    Article  PubMed  Google Scholar 

  6. Denoix PF (1950) Statistics on cancer morbidity new recommendations of the World Health Organization. Bull Assoc Fr Etud Cancer 37(4):273–280

    PubMed  CAS  Google Scholar 

  7. Flamant R et al (1964) Cancer of the tongue. A study of 904 Cases. Cancer 17:377–385

    Article  PubMed  CAS  Google Scholar 

  8. Denoix PF, Hayem G (1958) Indications for excision of cervical lymph nodes in cases of cancer of the mobile portion of the tongue without clinical signs of lymph node pathology. Mem Acad Chir (Paris) 84(18–19):592–597

    CAS  Google Scholar 

  9. Hibbert J, Marks NJ, Winter PJ et al (1983) Prognostic factors in oral squamous carcinoma and their relation to clinical staging. Clin Otolaryngol Allied Sci 8(3):197–203

    Article  PubMed  CAS  Google Scholar 

  10. Lee JG, Litton WB (1972) Occult regional metastasis: carcinoma of the oral tongue. Laryngoscope 82(7):1273–1281

    Article  PubMed  CAS  Google Scholar 

  11. Lenz M, Skalej M, Ozdoba C et al (989) Magnetic resonance tomography of the oral cavity, the oropharynx and the mouth floor: comparison with computed tomography. Rofo 150(4):425–433

    Article  Google Scholar 

  12. Boland PW, Watt-Smith SR, Pataridis K et al (2010) Evaluating lingual carcinoma for surgical management: what does volumetric measurement with MRI offer? Br J Radiol 83(995):927–933

    Article  PubMed  CAS  Google Scholar 

  13. Moore C, Flynn MB, Greenberg RA (1986) Evaluation of size in prognosis of oral cancer. Cancer 58(1):158–162

    Article  PubMed  CAS  Google Scholar 

  14. Ackerman MJ (1998) The Visible Human Project: a resource for anatomical visualization. Stud Health Technol Inform 52(Pt 2):1030–1032

    PubMed  Google Scholar 

  15. The University of Michigan Visible Human Project. Visible Human Browser—Female Dataset. Anatomic Browser. 2005 [cited 2009 26 November 2009]; Available from: http://vhp.med.umich.edu/browsers/female.html#

  16. Abd-El-Malek S (1939) Observations on the morphology of the human tongue. J Anat 73(Pt 2)):201–210 3

    PubMed  CAS  Google Scholar 

  17. Miyawaki K (1974) A study of the musculature of the human tongue. Ann Bull RILP 8:23–50

    Google Scholar 

  18. Gaige TA, Benner T, Wang R et al (2007) Three dimensional myoarchitecture of the human tongue determined in vivo by diffusion tensor imaging with tractography. J Magn Reson Imaging 26(3):654–661

    Article  PubMed  Google Scholar 

  19. Golding SJ, Wright H, Watt-Smith SR et al (2003) Analysis of intralingual anatomy and its variations: a pilot study. Eur Radiol 13(9):c11

    Google Scholar 

Download references

Acknowledgments

The Authors have no conflicts of interests or financial disclosures.

Author information

Authors and Affiliations

  1. Oxford Radiology Research Group, Oxford MRI Centre, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK

    Paul W. Boland, Kostas Pataridis, Karen A. Eley & Stephen J. Golding

  2. Nuffield Department of Surgical Sciences, Level 6 Academic Block, John Radcliffe Hospital, University of Oxford, Headley Way, Oxford, OX3 9DU, UK

    Karen A. Eley, Stephen J. Golding & Stephen R. Watt-Smith

Authors
  1. Paul W. Boland
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kostas Pataridis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karen A. Eley
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stephen J. Golding
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stephen R. Watt-Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Karen A. Eley.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Boland, P.W., Pataridis, K., Eley, K.A. et al. A detailed anatomical assessment of the lateral tongue extrinsic musculature, and proximity to the tongue mucosal surface. Does this confirm the current TNM T4a muscular subclassification?. Surg Radiol Anat 35, 559–564 (2013). https://doi.org/10.1007/s00276-013-1076-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-013-1076-6

Keywords

Search

Navigation