Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, United States.
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States.
Oral Oncol. 2023 Dec;147:106595. doi: 10.1016/j.oraloncology.2023.106595. Epub 2023 Oct 12.
OBJECTIVE(S): To characterize the change in sensory function following partial glossectomy for oral tongue cancer (OTC) and to identify predictors of loss of tongue-tip sensation (LoTTS).
Patients with at least three months follow-up after partial glossectomy for primary OTC were included. All patients underwent a qualitative tongue sensation assessment and an objective tongue sensory exam of the native tongue tip. Additional details regarding the oncologic resection, surgical reconstruction, and pathological stage were collected. Multiple linear and logistic regressions were used for statistical analysis.
Sixty-four patients were enrolled, including 34 (53%) men with a median age of 65 at enrollment. Ten (15%) patients reported LoTTS. Increased depth of resection (DOR) was an independent predictor of LoTTS on multivariate analysis, with an increased risk at a threshold of 1.3 cm. LoTTS was also associated with worse subjective quality of life and perceptive speech performance in our qualitative tongue assessment.
In this pilot study, we found that DOR is a critical prognostic factor in predicting post treatment function. Patients with an increased DOR, particularly above 1.3 cm, are at greatest risk of LoTTS and associated morbidity. These findings may be used to predict post-operative sensory deficits, manage patients' expectations, and optimize the reconstructive approach. Future studies are needed to validate and replicate our results.
描述口腔舌癌（OTC）部分舌切除术后感觉功能的变化，并确定舌尖感觉丧失（LoTTS）的预测因素。
纳入至少随访 3 个月的 OTC 部分舌切除术后患者。所有患者均进行了定性舌感觉评估和舌前感觉的客观检查。收集了关于肿瘤切除、手术重建和病理分期的更多详细信息。采用多元线性和逻辑回归进行统计分析。
共纳入 64 例患者，其中 34 例（53%）为男性，入组时的中位年龄为 65 岁。10 例（15%）患者报告存在 LoTTS。多变量分析显示，切除深度增加（DOR）是 LoTTS 的独立预测因素，当 DOR 阈值达到 1.3cm 时，风险增加。LoTTS 还与我们定性舌评估中的主观生活质量和感知言语表现较差相关。
在这项初步研究中，我们发现 DOR 是预测治疗后功能的关键预后因素。DOR 增加的患者，特别是超过 1.3cm 的患者，发生 LoTTS 和相关发病率的风险最大。这些发现可用于预测术后感觉缺陷，管理患者的预期，并优化重建方法。需要进一步的研究来验证和复制我们的结果。
