This book provides a comprehensive overview of the complex management of the oral tongue cavity. Oral tongue squamous cell carcinoma (OTSCC) is the most common cancer occurring in the oral cavity and is characterized by its aggressive malignancy and poorer prognosis compared to SCC in other oral locations. Radical surgery remains the primary treatment for OTSCC: the gold standard treatment for stages I-II OTSCC is transoral surgical excision. Conversely, stages III-IV OTSCC, with a DOI 10 mm, typically require 'en-bloc' tumor removal.
The principles of Compartmental Tongue Surgery (CTS), proposed by L. Calabrese et al. in 2011, are based on the concept of an "anatomy-based oncologic compartment," encompassing the primary tumor and its potential muscular, vascular, nervous, and lymphatic pathways of neoplastic spread. In CTS, the extrinsic tongue muscles, even partially infiltrated by the neoplasm, are meticulously dissected from their bony insertions. The notion of 'en-bloc' removal extends to all anatomical structures and stromal tissue at risk for tumor localization, connecting the primary tumor to the cervical lymph nodes, identified as the T-N tract .
Due to its structured anatomy and the limited surgical field, achieving significant surgical radicality in oral cavity cancer is often challenging. This unique book aims to elucidate the concept of the oncological compartment and systematically reviews the oncological outcomes and advantages of the authors' approach to OTSCC.
Additionally, it illustrates in detail practical, step-by-step guidance, from basic transoral to more complex compartmental emiglossectomy techniques for the management of tongue cancer. The authors share their knowledge and experience and provide common pearls and pitfalls in this specialized field.

Autorentext

This book is based on the life's work of the principal author, Dr. Calabrese, in the field of oral cavity surgery. Dr. Calabrese, who specialized in both plastic surgery and ENT, dedicated his career to head and neck oncology while working at the European Institute of Oncology in Milan. After conducting a thorough study of oral tongue anatomy and tumor diffusion in this area, Dr. Calabrese developed compartmental tongue surgery in 2009. This technique is rooted in anatomical principles and aims to radically remove tumors, including all possible neuronal and muscular infiltration pathways.
Over the years, this technique has consistently demonstrated its oncological and functional advantages. Following its successful implementation throughout northern Italy, Dr. Calabrese assumed the position of Director of the ENT and Head & Neck Surgery Department at Bolzano Hospital in 2017. The other three co-authors of this book, who are also specialized in head and neck oncology surgery, received their training at various oncological university centers (Dr. Abousiam in Padua, Dr. Gazzini in Verona, and Dr. Fazio in Varese).Since 2018, they have been working alongside Dr. Calabrese, forming a research group that has made significant efforts in developing and publishing the oncological outcomes of the compartmental approach to tongue cancer, as well as in disseminating the technique. This book serves as a practical guide for surgeons who are familiar with these advanced surgical techniques and wish to learn all of its intricacies.

Inhalt

1. Anatomy of the tongue.- 2. Aetiopathogenesis of oral tongue squamous cell carcinoma.- 3. Pathways of tumor spread and definition of the oncological compartment.- 4. Principles of compartmental surgery.- 5. Preoperative work-up.- 6. Management of early cancers.- 7. Management of advanced cancers.- 8. Management of the neck.- 9. Reconstruction and rehabilitation.