Oral tumours are a common malignancy, with smoking and alcohol the principal aetiological factors. Squamous cell carcinoma is the commonest pathology, most frequently affecting the anterior tongue and floor of the mouth. Surgery is the mainstay of T1/T2 tumour management, and tracheostomy may be required. Sentinel node biopsy is an effective staging procedure; however, there is a high rate of occult nodal metastasis which may warrant elective supraomohyoid neck dissection. Macroscopic nodal disease requires modified radical neck dissection, preferably with adjuvant chemoradiotherapy. For unresectable tumours, radical external beam radiotherapy with cisplatin should be given. Reconstruction of soft tissue involves a range of skin grafts and local, regional, and free flaps, while bony reconstruction includes obturators and non-vascularized and vascularized bone grafts. Postoperative rehabilitation aims to restore speech, mastication, swallow, and dentition. Three-year survival is greater than 90% for stage I/II disease, with excellent functional outcomes.
Supraomohyoid neck dissection for carcinoma of the tongue. A description of operative technique.