Sulcus Preservation to Improve Functional Outcomes in Compartmental Tongue Resection

Abstract

The primary aim of surgery in tongue cancers is tumor ablation with clear margins. Apart from tumor clearance, it is equally important to incorporate a technique that can improve the functional outcomes. It is a well-known fact that compartmental surgery has evolved as a propitious approach for early tongue and floor of mouth cancers. To overcome the functional deficits, we propose a technique of tongue reconstruction in cases where attached and reflected gingiva could be preserved when the tumor is not involving the floor of the mouth. We present a case series of three patients with our initial functional results in which this modified approach was performed. The parachute technique of flap inset maintained adequate sulcus. Regular sessions of speech and swallowing assessments were done and functional outcomes in these patients were assessed and compared with three other patients who underwent compartmental resection of tongue followed by interdental flap inset. Incorporation of a simple sulcus preservation technique by parachuting the remnant natural attached gingival mucosa after compartmental resection showed superior functional outcomes. It was also observed that the overall efficiency of chewing and clearance of food from oral cavity was better with this proposed technique as the lateral gutter was well maintained. The results of this study could help clinicians to provide a better functional outcome to the patients by this technique.