Prosthetic Management of Segmentally Resected Mandible and Partial Glossectomy: A Case Report

The balance and symmetry of mandibular function gets destroyed by the loss of continuity of the mandible, which deviates the residual fragment towards the resected side thereby altering the mandibular movements. Physical therapy in combination with prosthodontic treatment can be used to reduce the mandibular deviation and hence it improves the masticatory efficiency. Many prosthetic methods are discovered to minimize deviation and provide masticatory efficiency. Some of these methods are mandibular guide flange prosthesis, implant supported prosthesis and palatal guidance restoration. Contact of Tongue with palate is important for the production of normal speech, also the proper place of the tongue during certain sounds is important. In partial glossectomy conditions, tongue to palate articulation gets affected during speech and patient faces difficulty to pronounce certain sounds. For the rehabilitation of such patient thorough knowledge of the production of different sounds can be useful for diagnosis and treatment planning.

Variations in origin of the superior thyroid artery: an update for the head and neck surgeon

Head and neck surgeons must have a thorough knowledge of head and neck vascular anatomy and its variations. This case report documents a variation in the superior thyroid artery encountered during a neck dissection and discusses the surrounding literature. A 55-year-old female with squamous cell carcinoma of the tongue underwent a partial glossectomy, right level I–IV neck dissection and reconstruction with a radial forearm free flap. During the procedure, an arterial branch was encountered arising 2–3cm caudal to the common carotid bifurcation. This variant branch was shown to represent the superior thyroid artery. On review of the literature, various classification systems of the superior thyroid artery origin have been described. Awareness of such anatomical variation is vital for the head and neck surgeon to avoid unexpected complication.

Perioperative management of cranial diabetes insipidus in a patient requiring a tracheostomy

Cranial diabetes insipidus (DI), which can cause life-threatening dehydration, is treated with desmopressin, often intranasally. This is challenging in patients whose nasal airflow is altered, such as those requiring tracheostomy. We report the case of a patient, taking intranasal desmopressin for cranial DI, who underwent partial glossectomy, free-flap reconstruction and tracheostomy. Postoperatively, she could not administer nasal desmopressin due to reduced nasal airflow. She developed uncontrollable thirst, polyuria and hypernatraemia. Symptoms were relieved by switching to an enteric formulation. A literature review showed no cases of patients with DI encountering difficulties following tracheostomy. The Royal Society of Endocrinology recommends perioperative planning for such patients, but gives no specific guidance on medication delivery in the context of altered airway anatomy. Careful perioperative planning is required for head and neck patients with DI, particularly for those undergoing airway alteration that may necessitate a change in the mode of delivery of critical medications.

Endoscopic Harmonic Midline Partial Glossectomy in Obstructive Sleep Apnea

Aim: Our study was done to evaluate the role of Endoscopic posterior midline partial glossectomy as a surgical modality for the hypopharyngeal collapse in obstructive sleep apnea patients. Study design: Prospective case series study. Place and Duration of Study: Tanta university hospital, otolaryngology department, from October 2017 till March 2019. Methodology: This was a prospective case series study, conducted on 10 patients from 2017 -2019 with tongue base collapse and normal craniofacial angles, the patients were evaluated preoperative and 6 months postoperative subjectively by Epworth sleepiness scale (ESS) and objectively by polysomnography and lateral cephalometry. Results: Our study included 10 patients with age (mean ± SD48.70±4.08), BMI( mean ±SD24.45±1.56), 5 patients showed a significant reduction in AHI with a success rate of 50% with a significant change in ESS and the non-significant changes in cephalometric parameters. Conclusion: Transoral endoscopic posterior midline partial glossectomy can improve the surgical outcomes of obstructive sleep apnea patients.

Partial Glossectomy as an adjunct to Orthodontic Treatment of Anterior Open Bite Associated with Macroglossia: A Case Report

Orthodontic treatment of an anterior open bite is one of the most challenging malocclusions to treat, especially with respect to post-treatment stability. Complete diagnosis and targeted treatment is required for successful post treatment stability. In instances where macroglossia is the primary aetiology, partial glossectomy will greatly improve post treatment stability. The following case report describes a patient with severe anterior open bite and bimaxillary protrusion secondary to macroglossia. Treatment was successfully performed with partial glossectomy and straight wire orthodontics. Post-treatment relapse was minimal. CPD/Clinical Relevance: This article describes a review of the aetiology of anterior open bite and documents one possible treatment option, when the main aetiology of the malocclusion is of soft tissue origin