4 Glossectomy

Question 1

What is a glossectomy?

Answer 1

surgical procedure that removes part or all of the tongue

Question 2

The tongue is a muscular hydrostatic. What does that mean? (2)

Answer 2

• a muscular structure without a skeleton used to move/manipulate objects (e.g., food)
• able to move tongue without an anchor

Question 3

Name other muscular hydrostatic examples.

Answer 3

squid, worm, elephant trunks

Question 4

Muscular hydrostats make use of the fact that muscle tissue is _____________ at physiological pressures.

Answer 4

incompressible

Question 5

T/F: Regarding lingual taste, taste buds for the 5 flavours are distributed relatively evenly across the tongue.

Answer 5

True

Question 6

What are the 5 basic flavours?

Answer 6

1. sweet
2. salty
3. sour
4. bitter
5. umami

Question 7

What are 2 screeners of oral cancer?

Answer 7

1. fluorescence testing
2. blue dye testing

Question 8

For oral cancers, preferred tx is…

Answer 8

surgery

Question 9

T/F: We use the tongue’s full strength & range for speech.

Answer 9

False

Usually, we don’t use full tongue strength & range

Question 10

Compare mobility (1) vs motility (3).

Answer 10

Mobility = passive movability

Motility = active ability to move
- not seen by the surgeon
- important for when there is a bigger defect

Question 11

Name the 4 types of defect reconstruction.

Answer 11

1. primary wound healing
2. local closure
3. local flap/pedicle flap closure
4. free flap closure

Question 12

Describe the defect reconstruction: primary wound healing (2)

Answer 12

• the defect is left open to heal
• works if the defect is small enough

Question 13

Describe the defect reconstruction: local closure (3)

Answer 13

• surrounding tissue is closed over the defect
• take margins of resection & stitch it together
• if defect is large, cannot leave it open

Question 14

T/F: In a local closure procedure, it may involve restitching to muscles if it is large enough

Answer 14

True

Question 15

Describe the defect reconstruction: local flap / pedicle flap closure. (2)

Answer 15

• a tissue flap is lifted close to the defect
• retains it original blood supply

Question 16

Describe the defect reconstruction: free flap closure (2)

Answer 16

• tissue is lifted somewhere else on the body & transplanted into the defect site
• requires connection to tiny local blood vessels (anastomosis)

Question 17

T/F: Local flap offers more options of what can be done.

Answer 17

False

Free flap offers more options of what can be done (e.g., allows for a bigger reconstruction)

Question 18

What is the first step for the SLP when working with someone who has had cancer? (1)

Answer 18

figure out what is going on in the patient’s oral cavity

Question 19

The cut-off for poorer speech acceptability estimated at _____% resection of tongue surface.

Answer 19

20.4%

Question 20

Which is better than the other, accessibility or intelligibility?

Answer 20

Accessibility > intelligibility

Question 21

If more than 1/5 is resected than there is a _________ in acceptability.

Answer 21

decrease

Question 22

After a partial glossectomy, when you do not succeed on first try, what do you try next?

Answer 22

rehabilitation/speech therapy!

Question 23

What are 4 secondary compensatory strategies aimed at increased intelligibility in glossectomees?

Answer 23

1. lengthening of vowel duration
2. reduction or increase of vocal intensity
3. reduction of rate & intentional use of meaningful pauses
4. widening of pitch range & variability

Question 24

What are reccommendations for the therapy of partial glossectomees? (3)

Answer 24

• maximize mobility & motility of residual tissue (tongue motility exercises)
• re-establish articulatory targets consistent with the movement capabilities of the structures
• improve the speaker’s ability to achieve speech sound differentiation

Question 25

What is palatal augmentation prosthesis useful for? (1) Speech benefits?

Answer 25

- useful for food manipulation & swallowing in some patients - benefits for speech is unclear

Question 26

Which feeding tools did we look at in class? (4)

Answer 26

- feeding syringe - wash bottle - glossectomy feeding spoon - gravity sup for flow regulator

Question 26

A recommendation for the therapy of total glossectomees was speech compensations, for which sounds? (7)

Answer 26

s, z r t, d k, g

Question 27

What 3 types of prostheses did we discuss in class?

Answer 27

1. maxillary obturator 2. palatal obturator 3. facial epithesis