• Title/Summary/Keyword: tongue cancer

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Continuous Intraventricular Morphine Infusion for Control of Pain in Terminal Cancer Patients (말기 암성통증 환자의 통증제거를 위한 지속적 뇌실내 몰핀 주입)

  • Kim, Chul-Ho
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.69-75
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    • 1992
  • The author experienced of four patients with intractable pain who were treated by continuous intraventricular infusion of morphine through an implanted port system. One suffered from tongue cancer and the others from bone metastasis or distant metatasis of abdominal cancer which were ineffectively to managed through an epidural route. Our experience is that this is a safe and effective method of pain management in patients with head and neck cancer. It is useful as well in patients who have intractable pain that cannot be managed through an intrathecal or epidural route.

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Clinical and Therapeutic Aspects of Squamous Cell Carcinoma of Oral Tongue (구강 설 편평 상피 세포암의 임상적, 치료적 고찰)

  • Ryu Samuel;Lee Chang Gul;Park In Kyu;Suh Chang Ok;Kim Gwi Eon;Loh John J.K.
    • Radiation Oncology Journal
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    • v.5 no.2
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    • pp.105-110
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    • 1987
  • Fourty nine patients with squamous cell carcinoma of oral tongue were reviewed retrospectively for the evaluation of clinical manifestation and for the comparison between therapeutic modalites. The gross shape of the tumor was infiltrative in 22, ulcerative in 12, ad ulcer-oinfiltrative type in 10 patients. Direct extension of the tumor was most commonly to the floor of the mouth. The incidence of nodal metastasis generally increased with tumor stage. $55\%$ of the patients showed neck nodal metastasis at the time of diagnosis. Ipsilateral subdigastric node were most commonly involved, followed by submandibular nodes. The 5-year survival rate of patients treated with surgery and radiotherapy was $58.7\%$ in contrast to $21.6\%$ in radiation alone group. Overall 5-year survival rate was $31\%$ In radiation alone group, half of the patients in stage I, II were locally controlled. But the local control In stage III, IV was much inferior to early lesions. Especially, of 4 patients combined with implantation technique, 3 were completely controlled. 5-year survival rate of these implanted patients was $50\%,\;49.4\%$ of patients treated over 7,000cGy survived 5 years. This was significant in contrast to $6.4\%$ of the group treated below 7,000cGy. The most common sites of failures were primary sites. In early lesions primary radiotherapy with implantation would be an appropriate treatment in cancer of oral tongue, operation reserved for radiation failure. Operation and adjuvant radiotherapy is recommended in cases of advanced disease.

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Analysis of Free Flap Reconstruction of the Tongue (유리피판을 이용한 설재건술의 분석)

  • Kang, Dong Hee;Lee, Hyung Chul;Koo, Sang Hwan;Park, Seung Ha;Jung, Kwang Yoon
    • Archives of Plastic Surgery
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    • v.33 no.5
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    • pp.557-562
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    • 2006
  • Purpose: Advanced carcinoma of the tongue is a devastating disease which may cause severe speech or swallowing dysfunction. But, none to date has provided all of the complex functions of the tongue. The purpose of this study is to review our experiences with individuals who underwent glossectomy followed by reconstruction using free tissue transfer. Methods: Between February 1998 and February 2005, twenty-four patients underwent glossectomy followed by free tissue transfer reconstruction. The defects of tongue caused by partial or subtotal glossectomy were reconstructed by means of radial forearm or lateral thigh free flap with nerve innervation. Especially for the patients who underwent total glossectomy, we reconstructed deglutition muscles anatomically with nerve reinnervation, a procedure that allows the grafted muscle to maintain good tongue bulk without obvious atrophy. Results: Patients were reviewed to determine their functional outcome as it related to speech, deglutition, and aspiration. All patients achieved oral intake of a soft diet and acceptable speech. Conclusion: Although reconstruction following glossectomy using free tissue transfer is not ideal, this procedure is safe and reliable, and provides predictable results. A future challenge is the development of a surgical procedure for reconstruction of a tongue that maintains mobility and sensation using neurotized flaps.

Functional Assessment after Tongue Reconstruction using Free Flap (유리피판을 이용한 설재건 후의 기능평가)

  • Park, Sung-Ho;Chung, Chul-Hoon;Lee, Jong-Wook;Chang, Yong-Joon;Rho, Young-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.2
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    • pp.119-122
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    • 2009
  • Objectives : Ablation of carcinoma of the tongue leads to deficits in speech and swallowing, but none to date has provided all of the qualities of mobility and sensation to simulate the complex function of the tongue. The authors evaluated postoperative swallowing and pronouncing function in patients who underwent tongue reconstruction using free flap. Material and Methods : This is a retrospective review documenting the outcome of 42 patients between January of 1991 and August of 2008. We classified patients according to the size of resection of the tongue like as 7 partial glossectomy, 25 hemiglossectomy, 2 subtotal glossectomy, and 8 total glossectomy. Swallowing function was graded into 4 point scale and pronouncing function was analyzed using picture consonant articulation test. Aspiration was evaluated with videofluoroscopic swallowing study. Results : The average points for swallowing function were 3.43 in partial glossectomy, 3.52 in hemiglossectomy, 3 in subtotal glossectomy, and 2.63 in total glossectomy. The percentage of consonants correct showed 76.5% in partial glossectomy, 72.29% in hemiglossectomy, 47.69% in subtotal glossectomy, and 29.94% in total glossectomy. Aspiration was noted in 3 patients(1 hemiglossectomy and 2 total glossectomy) and 2 total glossectomy patients were taken permanent feeding gastrostomy. Conclusion : Free flap gave us proper volume in tongue reconstruction and showed good result in preserving swallowing function. Swallowing function difference according to the size of defect showed no statistical significance, whereas articulation function was shown to decrease in accuracy as the size of defect was larger.

AN ATOPIC NUDE MOUSE MODEL OF ORAL CANCER CELL LINE (구강암 세포주의 이소위 누드마우스 종양 모델)

  • Kim, Jong-Hyun;Hwang, Young-Sun;Kim, Hyun-Sil;Nam, Woong;Cha, In-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.2
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    • pp.74-82
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    • 2009
  • In order to make successful oral cancer treatment, we need to understand about tumor biology and effective chemotherapeutic agents. To achieve these studies, it is necessary to develope a proper in-vivo model. Therefore the author will make try to develop more improved animal model of more applicable in various method of cancer study. In this study, the author induced in-vivo tumorigenesis in nude mice by $YD-10B_{mod}$ cell line used by YD-10B cell line originated from oral tongue squamous cell carcinoma and observed tumor formations and invasiveness of surrounding tissue, and found some results as follows : 1. The experimental group($YD-10B_{mod}$, subcutaneous injection) produced tumors 13 out of 15 mice, while the control group produced none of 5 mice. 2. The inoculation of $1{\times}10^6$cells/mouse produced tumors 3 out of 5 mice and inoculation of $1{\times}10^7$cells/mouse, $2{\times}10^7$cells/mouse produced tumors in every 5 mice. 3. In the histopathologic studies, the inoculation of $1{\times}10^6$cells/mouse group showed the characteristic features of well-differentiated squamous cell carcinoma and demarcated expansile growth, while the inoculation of $1{\times}10^7$cells/mouse, $2{\times}10^7$cells/mouse group showed the expansile growth with partial central necrosis and invasive growth to surrounding fat & connective tissue. These findings suggest that atopic xenograft of $YD-10B_{mod}$ cell line in nude mice has a improved productivity of tumors, produced tumors showed the characteristics feature of human tumor and invasive growth to surrounding tissue in histopathologic appearance. These atopic nude mouse model of tongue carcinoma might assist in studying oral cancer biology and effective choice of chemotherapeutic agents.

Survival in Head and Neck Cancers - Results of A Multi-Institution Study

  • Nandakumar, Ambakumar
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1745-1754
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    • 2016
  • Background: The prime output of Hospital Based Cancer Registries is stage and treatment based survival to evaluate patient care, but because of challenges of obtaining follow-up details a separate study on Patterns of Care and Survival for selected sites was initiated under the National Cancer Registry Programme of India. The results of stage and treatment based survival for head and neck cancers by individual organ sites are presented. Materials and Methods: A standardized Patient Information Form recorded the details and entered on-line at www.hbccrindia.org to a central repository - National Centre for Disease Informatics and Research. Cases from 12 institutions diagnosed between 1 January 2006 and 31 December 2008 comprised the study subjects. The patterns of treatment were examined for 14053 and survival for 4773 patients from five institutions who reported at least 70% follow-up as of 31 December 2012. Results: Surgical treatment with radiation for cancer tongue and mouth showed five year cumulative survival (FCS) of 67.5% and 60.4% respectively for locally advanced stage. Chemo-radiation compared to radiation alone showed better survival benefit of around 15% in both oro and hypo-pharyngeal cancers and their FCS was 40.0%; Hazard Ratio (HR):1.5;CI=1.2-1.9) and 38.7%; (HR):1.7; CI=1.3-2.2). Conclusions: The awareness about the requirement of concurrent chemo-radiation in specifically cancers of the oro and hypopharynx has to be promoted in developing countries. The annual (2014) estimate number of new Head and Neck cancers with locally advanced disease in India is around 140,000 and 91,000 (65%) patients do not receive the benefit of optimal treatment with ensuing poorer survival.

Free Rectus Muscle or Myocutaneous Flap for Reconstruction on the Various Sites (다양한 부위의 재건에 있어 유리복직근 피판술의 이용)

  • Ahn, Ki-Young;Lee, Jae-Wook;Han, Dong-Gil
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.80-91
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    • 1996
  • A free rectus abdominis flap can include a variable amount of muscle length depending on recipient site requirements. There is also great flexibility in flap design in terms of size, orientation of its axis, and the level of its location over the muscle. It is safe to design the skin island across the midline. Though skin islands designed over the most inferior portion of the abdomen have not always proved reliable when based on the superior epigastric artery, free flaps based on the inferior pedicle can be successfully designed in this area. As free flap based on the inferior epigastric vessels, this flap has been useful for large head and neck defects following ablative procedures, for facial contour restoration as a buried flap, for upper extremity defects, for lower extremity defects such as coverage of grade III tibial fractures and for breast reconstruction. A free rectus abdominis muscle or myocutaneus flap was used in 8 patients. The operations were performed between Sep. of 1994 and April of 1996. The patients were tongue cancer 1 case, chronic facial palsy 1 case, unilateral breast reconstruction 1 case, upper and lower extremity injury 5 cases. The free rectus abdominis muscle flaps were 4 cases and the free myocutaneous flaps were 4 cases. There was no failure of the flap, except one partial necrosis. One case of the skin grafts on the muscle flap was regrafted. One case of reoperation due to venous thrombosis was performed. In tongue cancer patient, a orocutaneous fistula was occurred, but conservative treatment and secondandry skin graft were done. In conclusion, a free rectus abdominis flap has many advantages such as a long and constant pedicle, easy dissection, enough soft tissue available, scar on the donor site to be hiddened, no need for changing position. So we think that this flap is the most useful one for small or moderate sized defects on the various sites.

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