Median approach resection of benign tumor at base of tongue

Although the incidence of tumors at the base of the tongue is lower than that of the tongue, it is also common, and both benign and malignant. According to clinical statistics, tumors at the base of the tongue are more common. Therefore, the approach of the benign tumor resection of the tongue base described in this section is also applicable to malignant tumors. The base of the tongue is located behind the mouth, the field of vision is unclear, and the operation is inconvenient. Sensitive pharyngeal reflexes cause nausea and even vomiting, which makes it difficult to check and treat. The tongue root tumor is also often involved in the throat, and the edema reaction and hematoma after surgery can cause airway obstruction and even suffocation and death. Therefore, the key to the success of benign tumor resection of the tongue is the surgical approach and surgical safety issues. At present, there are four types of median approach, side approach, pharyngeal advancement and intraoral approach. Clinically, it should be correctly selected according to the systemic and local conditions of the patient, especially the specific location and size of the tumor and the nature of the tumor. After the removal of the tumor at the base of the tongue, there will be some functional effects due to the defect and deformity of the tissue. After the tumor is too large or too deep, there is still a problem of closure and repair of the wound, which should be considered in the design of the operation. The issues related to the approach are highlighted here. Related issues related to tumor resection of the base of the tongue have been described in the previous section. Treatment of diseases: sublingual cysts Indication The median approach to the removal of the base of the tongue is suitable for cases with large tumors in benign tumors. Because the field is clear and sufficient, it is good for correct operation, so it is also suitable for cases requiring major excision of the base of the tongue. For the malignant tumor of the tongue that needs to be enlarged and repaired immediately, it is more advantageous to use this approach during surgery. Contraindications There is no special surgical contraindication for the removal of benign giant tumors at the base of the tongue by the median approach. However, it is worth noting that the disadvantage of this method is that it is more traumatic than the intraoral approach and has more damage to the normal tissue structure. Therefore, the tongue root volume is small and the position is small. Further preoperative tumor resection should take other approaches to reduce damage to normal tissue. Surgical procedure Incision A vertical incision is made from the middle of the lower lip through the ankle, reaching the iliac crest and continuing to extend to the hyoid bone. 2. Approach and reveal tumor Cut through the layers, ligature and stop bleeding, pay special attention to the ligation of the labial arteries. Remove the two incisors of the lower jaw, cut the bone with a wire saw along the middle of the mandible, and pull it to both sides, then cut the bottom of the opening and the tongue along the midline, then reach the base of the tongue, and pull the tongue to both sides to fully reveal Tumor. For the tumor located on the side of the base of the tongue, the mandible can be sawed after the incision of the lower lip, and the lingual approach along the tongue and mandible can be reached to the base of the tongue, but the lingual nerve must be dissected first to protect the affected side. The lingual artery can be ligated. 3. Resection of the tumor The tumor was completely removed according to the principle and method of excising the tongue tumor as described in the previous section. 4. Layered stitching. 5. Drainage The tongue tissue is completely hemostasis, tightly sutured, and generally no drainage is placed. Negative pressure drainage or half-tube drainage should be placed on the inferior orbital incision. 6. Aseptic dressing to dress the wound.