A new surgical technique pioneered at the University of Alberta has given back the ability to swallow to patients with tongue cancer.
By modifying an existing technique of transplanting tissue from a patient's forearm to his tongue, surgeons can provide enough bulk to help improve the vital process of swallowing. The modification involves including a 'jellyroll'of fat and connective tissue along with the tissue and skin of the forearm to replace the diseased tongue tissue that is removed if a patient opts for surgical treatment of the cancer. The surgery is then followed up with radiation or chemotherapy, but that shrinks and scars the tongue, turning normally elastic and pliable tissue to something like wood. This reduces the patient's ability to swallow to the point that they must be fed through a tube placed through their skin directly into the stomach, because they can't take enough food to maintain their calorie requirements.
The so-called 'beavertail' modification adds more bulk to the tongue, helping protect it from the effects of radiotherapy.
The study's findings support the position that the surgery is just as effective as the standard treatment of combined chemotherapy and radiotherapy, but the surgical technique also preserves the patient's ability to swallow, said Dr. Dan O'Connell, lead author on the study and a surgical resident in the University of Alberta's Division of Otolarynology Head and Neck Surgery.
"Other centres in Canada treat patients using radiotherapy and chemotherapy alone, and it was thought that the results were as good or better than what any surgery could do," O'Connell said. "But we found that by adding that jellyroll of tissue, you give the tongue ability to compensate for its lack of mobility." The technique, developed by Dr. Hadi Seikaly and Dr. Jeff Harris, preserves the patient's ability to swallow after treatment.