TONGUE CANCER
Oral cavity cancers are 2nd most common cancer in India all age groups according to GLOBOCAN 2020. They are most common cancers in males and 4th common among females. Tobacco smoking and alcohol are major risk factors. Squamous cell carcinoma is being most common histology. Tongue common site among oral cavity cancers.
Tongue has anterior 2/3rd part comes in oral cavity and posterior 1/3rd part (base of tongue) comes in oropharnyx. Resection of tumors located posterior aspect anterior 2/3rd tongue or TL junction located tumors becomes tricky as there is a chance of communication with neck, accessibility issues and in cases where there is sub mucous fibrosis. Mandibulotomy is a unique approach by taking mandible as a part of cheek flap. Merits of it - better exposure and resection of posteriorly placed tongue lesion and easier placement of free flap.
55 years old gentleman with hypertension as comorbidity evaluated for ulcer over left lateral border tongue near TL junction. Clinics-radiologically base of tongue and floor of mouth was free. He underwent left hemiglossectomy after doing mandibulotomy for posterior access with left modified radical neck dissection (nerve and vein preserved) and reconstructed with free radial artery forearm flap. Mandibulotomy site was refixed using a plate.