Comparative study of functional outcomes following surgical treatment of early tongue cancer

Enhancing NIR-II Imaging and Photothermal Therapy for Improved Oral Cancer Theranostics by Combining TICT and Aggregation-Induced Emission

In the treatment process of cancers like oral cancer, it is necessary to employ extensive surgical resection to achieve cancer eradication. However, this often results in damage to crucial functions such as chewing and speaking, leading to a poorer prognosis and a reduced quality of life. To address this issue, a multifunctional theranostic agent named MBPN-T-BTD has been developed by precisely modulating the excitation state energy distribution in the radiative/nonradiative decay pathways using the characteristics of twisted intramolecular charge transfer and aggregation-induced emission. This agent outperforms clinically utilized indocyanine green (ICG) in various aspects, including the second near-infrared window (NIR-II, 1000-1700 nm) fluorescence (FL) and photothermal conversion efficiency (PCE). Its nanoparticle form (BTB NPs) can be effectively used for high-contrast delineation of lymph node mapping and tongue and floor of mouth cancers using NIR-II FL, enabling surgeons to achieve more precise and thorough tumor clearance. For tumors located in close proximity to vital organs such as the tongue, the exceptional PCE (71.96%) of BTB NPs allows for targeted photothermal ablation with minimal damage to peripheral healthy tissues. This contribution provides a safer and more effective paradigm for minimally invasive or noninvasive treatment of oral cancer, ensuring the preservation of normal organ functions and showing potential for improving the overall prognosis and quality of life for cancer patients.

Tongue Reconstruction with Buccinator Myomucosal Island Flaps: Technical Considerations, Oncologic Safety, Functional Outcomes and QoL Assessment-A Retrospective Observational Study

The objective of this study was to investigate the effectiveness of buccinator myomucosal island flaps for tongue reconstruction following malignant tumor resections. A retrospective study was performed on 52 patients who underwent tongue reconstructions with buccinator myomucosal island flaps between 2012 and 2020. We reviewed the flap type and size, harvesting time, recipient- and donor-site complications, postoperative oncologic outcomes, functional recovery and QoL assessment. All of the flaps were transposed successfully without any total flap loss. Neither in the primary site nor in the neck were cancer relapses observed. An evaluation of the sensitivity revealed that 96.1% of patients experienced a recovery of touch, two-point and pain sensations. There were significant differences between the flap and the native mucosa in terms of the tactile (p < 0.001), pain (p < 0.001) and two-point (p < 0.001) thresholds. The average swallowing score recorded was 6.1 out of 7, with only minor complaints. The quality of life assessments demonstrated high scores across physical (24.5 out of 28), social (25.8 out of 28), emotional (20.3 out of 24) and functional (25 out of 28) aspects. The present study showed how buccinator myomucosal island flaps represent an effective and functional tongue reconstructive option, requiring a short operative time with a low rate of donor site morbidity, and with evidence of long-term oncologic safety and high quality of life.

Oral Cavity Reconstruction

This summary provides a concise overview of oral cavity reconstruction to optimize functional outcomes in the modern era. Soft tissue and osseous reconstruction options for a wide range of oral cavity sites including lip, oral tongue, floor of mouth, buccal, hard palate, and composite oromandibular resections are reviewed. The appropriate applications of primary closure, secondary intention, skin grafts, and dermal substitute grafts are included. Anatomic considerations, indications, contraindications, and complications of local, regional, and free flaps in oral cavity reconstruction are discussed. Specific defects and the appropriate options for reconstruction of those defects are delineated.

Advances in oral tongue reconstruction: a reconstructive paradigm and review of functional outcomes

PURPOSE OF REVIEW

Glossectomy remains a common treatment of oral tongue malignancies, which has a range of functional impacts depending on the extent of resection. This review aims to categorize and provide context for the approach to reconstructing these defects using recent evidence.

RECENT FINDINGS

The reconstruction method of choice should be tailored to the size and location of the glossectomy defect with special consideration to replace tongue volume and preserve mobility. There has been an increasing focus on patient-reported outcomes in oral tongue reconstruction. For defects beyond one-third of the tongue, free tissue reconstruction, and more recently, the submental artery island flap yield excellent results. Advances in reconstruction of larger defects have included preoperative soft tissue planning and assessment of outcomes in total glossectomy patients with laryngeal preservation.

SUMMARY

Depending on the defect, the appropriate reconstruction may range from healing by secondary intention to large volume free tissue transfer. In general, functional outcomes diminish with increasing size and complexity of the defect regardless of the reconstructive technique.