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Management by Total Glossectomy Without Laryngectomy

Morris Z. Effron, MD; Jonas T. Johnson, MD; Eugene N. Myers, MD; Hugh Curtin, MD; Quinter Beery, PhD; Barbara Sigler, RN

Arch Otolaryngol. 1981;107(11):694-697.

Abstract
• 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 faradvanced disease, often after failure of other treatment modalities. As a result, they may be suffering from constant pain as well as 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 not have sufficient follow-up to assess cure rates. However, our initial results have been encouraging. Our series does show that properly selected patients can be successfully rehabilitated after total glossectomy without 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.

(Arch Otolaryngol 1981;107:694-697)

Author Affiliations
From the Departments of Otolaryngology (Drs Effron, Johnson, and Myers and Ms Sigler), Radiology (Dr Curtin), Speech Therapy (Dr Beery), University of Pittsburgh School of Medicine, Eye and Ear Hospital.

Footnotes
Accepted for publication May 7, 1981.

Read before the combined meeting of the Society of Head and Neck Surgeons and the American Society for Head and Neck Surgery, Phoenix, Ariz, March 11, 1981.

Reprint requests to the Department of Otolaryngology, University of Pittsburgh School of Medicine, Eye and Ear Hospital, 230 Lothrop St, Pittsburgh, PA 15213 (Dr Effron).

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