OBJECTIVE: The surgical approach for resection and reconstruction of tongue cancer (TSCC) with or without the lip-splitting incision is controversial. This study introduced a modified approach without lip-splitting and the clinical results were assessed.
METHODS: Sixty-eight TSCC patients underwent surgery using the modified submandibular mandibulotomy (MSMM) approach without lip-splitting, and another matched 68 patients using lip-splitting mandibulotomy (LSM) approach were enrolled in this study. The clinical results including intraoperative relevance and surgical morbidities, survival status, facial appearance and scar scores, function of lower lip, and quality of life (QOL) were evaluated.
RESULTS: The primary tumors were en bloc resected through the MSMM approach with excellent tumor exposure and R0 resection margins as LSM approach. The survival status and complications were similar in both groups. The function of lower lip was better in patients of MSMM group at 1 month after surgery. The MSMM approach was associated with significantly better facial appearance and recreation compared to LSM approach by scar scores and QOL assessment.
CONCLUSIONS: The MSMM approach without lip-splitting achieves similar tumor control, better aesthetic results, and QOL compared to LSM approach. It is a safe and effective surgical approach for patients with TSCC.
CONCLUSIONS: The MSMM approach without lip-splitting is oncological safety in tongue cancer surgery and is scrutinized as one part of the treatment concept for better aesthetic results.

Lip-splitting approach for oncologic resection and defect reconstruction of tongue squamous cell carcinoma (TSCC) needs modification to avoid unfavorable esthetic results. Forty-three patients with TSCC underwent surgery using the modified submandibular mandibulotomy(MSMM) approach without lip-splitting and another matched 43 patients using lip-splitting mandibulotomy (LSM) approach were reviewed retrospectively. Clinical outcomes evaluation consisted of tumor exposure, resection margin, surgical morbidity, locoregional recurrence, survival status, scar scores and quality of life (QOL). All the tumors were en bolc removed by MSMM approach and LSM approach through combined intraoral routes with excellent tumor exposure and R0 resection margins. Tumor recurrence rates and swallowing, chewing, speech were similar in both groups. The MSMM approach was associated with significantly better facial appearance and recreation than LSM approach. The MSMM approach without lip-splitting is safe and effective, achieves better QOL compared to LSM approach in patients with TSCC.

OBJECTIVE: This study aimed to compare the influences of postoperative oral function in patients with median or paramedian mandibulotomy during the radical resection of tongue carcinoma and to provide evidence for the choice of osteotomy location for mandibulotomy.
METHODS: The clinical data of 126 patients who underwent combined radical neck dissection with mandibulectomy and glossectomy followed by simultaneous reconstruction were analyzed retrospectively. The patients were divided into two groups according to the position of mandibulotomy: median mandibulotomy group (median group, n=60) and paramedian mandibulotomy group (paramedian group, n=66). The fourth edition of the University of Washington Quality of Life Questionnaire (UW-QOL) was used to compare the differences in oral functions, such as swallowing, mastication, and speech, between the two groups during regular follow-up. SPSS 24.0 software package was used for statistical analysis, and P<0.05 was considered statistically significant.
RESULTS: Six months after the operation, no significant differences in swallowing, mastication, and speech functions were found between the median and paramedian groups. However, the swallowing and speech functions in the paramedian group were better than those in the median group 1 year after the operation (P<0.05), whereas no statistical difference in mastication function was observed between the two groups.
CONCLUSIONS: Evaluation of the postoperative oral function results showed that paramedian mandibulotomy was a better surgical approach than median mandibulotomy. Paramedian mandibulotomy is worth prioritizing in the radical resection of tongue carcinoma.
目的 比较正中或旁正中下颌骨截骨术对舌癌患者口腔功能的影响，为下颌骨截骨位置的选择提供依据。方法 回顾性分析经下颌骨截骨入路进行舌颌颈联合根治及缺损修复重建的126例舌癌患者的临床资料。根据截开下颌骨位置的不同，分为下颌骨正中截骨术组（正中组，n=60）和下颌骨旁正中截骨术组（旁正中组，n=66）。术后定期随访，应用华盛顿大学生存质量问卷（UW-QOL）第四版比较2组患者术后吞咽、咀嚼和语音等口腔功能的差异。采用SPSS 24.0软件包进行统计学处理，P<0.05为差异有统计学意义。结果 术后6月，正中组与旁正中组吞咽、咀嚼及语音功能评分差异均无统计学意义；术后1年，旁正中组患者吞咽和语音功能评分优于正中组（P<0.05），但咀嚼功能评分差异无统计学意义。结论 经旁正中下颌骨截骨入路进行舌颌颈联合根治，术后患者口腔功能优于经正中下颌骨截骨入路。.

This study aims to compare the prognoses outcomes of mandibular preservation method (MPM) and the mandibulotomy approach (MLA) in oral and oropharyngeal cancer (OOPC) patients.
We searched PubMed, Web of Science, EMBASE, Chinese BioMedical Literature Database (CBM), Cochrane Library, and clinicaltrials.gov up to September 2016 to identify the studies that compared the prognoses of the MPM versus the MLA in OOPC patients. Two authors individually extracted the data and performed quality assessment. The surgical margins, overall survival rate, total and local recurrence rates, fistula formation, and other functional outcomes were evaluated.
Six studies with 309 patients were included in our analysis. No significant difference was found regarding the surgical margins, overall survival rate, total and local recurrence rates, and speech and tongue movement between the MPM and MLA groups. However, the MPM group showed a significantly lower fistula formation rate than the MLA group after the operation.
These findings suggest that the MPM may provide a similar clinical outcome to the MLA, but that the MPM has a lower complication rate in the treatment of OOPC patients.