Mandibular lingual release versus mandibular lip-split approach for expanded resection of middle-late tongue cancer: A case-control study.

Objective: The mandibular lingual release (MLR) and mandibular lip-split (MS) approaches are the two common access approaches for resection of malignant tongue tumors. This case-control study aimed to evaluate the effectiveness and safety of these two approaches for the expanded resection of middle-late tongue cancer.

Material And Methods: A total of 56 matched patients with resectable middle-late squamous cell carcinoma of the tongue body were consecutively hospitalized for expanded resection using the MLR (n = 26) or MS approach (n = 30) between March 2004 and November 2012. Main outcome measures consisted of tumor exposure, surgical morbidity, maxillofacial motor-sensory return, and head/neck-specific quality of life.

Results: The two approaches achieved similar en bloc R0 resection with similar tumor exposure. The MLR approach was associated with a significantly lower frequency of maxillofacial pain (P < 0.05) and no incidence of mandible nonunion. The MLR approach was also associated with a significantly better quality of life with respect to local pain, facial appearance, and mood.

Conclusion: Compared to the MS approach, the MLR approach was associated with significantly less surgical morbidity and a significantly better quality of life for middle-late tongue cancer patients undergoing expanded resection.