Effron M Z, Johnson J T, Myers E N, Curtin H, Beery Q, Sigler B
Arch Otolaryngol. 1981 Nov;107(11):694-7. doi: 10.1001/archotol.1981.00790470042010.
A major goal of any surgical program for patients with tumors is to cure their cancer. Patients requiring total glossectomy usually are seen initially with far-advanced disease, often after failure of other treatment modalities. As a result, they may be suffering from constant pain as well impairment of speech and deglutition. The prognosis is poor, and palliative surgery with good rehabilitation of the speaking and swallowing mechanisms becomes a reasonable, albeit limited, objective. Our series does show that properly selected patients can be successfully rehabilitated after total glossectomy with out laryngectomy. This successful rehabilitation begins with good patient selection and preoperative preparation. Postoperative rehabilitation requires the interplay of a highly motivated patient and a well-coordinated health care team. The physician, nurse, speech pathologist, dietitian, and social worker all have important roles in ensuring the patient's return to a good quality of life. The surgeon will direct the efforts of the team. To the nurse and the speech pathologist falls much of the bedside job of instructing and motivating the patient. Because such effective rehabilitation has been demonstrated by the success of our patients, we advocate preserving the larynx whenever possible in the patient who must undergo total glossectomy.
任何针对肿瘤患者的外科治疗方案的主要目标都是治愈他们的癌症。需要进行全舌切除术的患者通常最初就诊时病情已发展到晚期，往往是在其他治疗方式失败之后。因此，他们可能一直遭受疼痛，同时存在言语和吞咽功能障碍。预后很差，对言语和吞咽机制进行良好康复的姑息性手术成为一个合理的目标，尽管有限。我们的系列研究确实表明，经过适当选择的患者在不进行喉切除术的全舌切除术后能够成功康复。这种成功的康复始于良好的患者选择和术前准备。术后康复需要积极主动的患者与协调良好的医疗团队之间的相互配合。医生、护士、言语病理学家、营养师和社会工作者在确保患者恢复良好生活质量方面都发挥着重要作用。外科医生将指导团队的工作。指导和激励患者的大部分床边工作落在护士和言语病理学家身上。由于我们的患者取得了成功，证明了这种有效的康复，我们主张在必须进行全舌切除术的患者中尽可能保留喉部。
