Mouth ulcers but subjective, man had to have his entire tongue removed

Subjective with symptoms of mouth ulcers

On August 5, Viet Duc Friendship Hospital announced that it had just received a male patient over 60 years old, Dao ethnic group, in a state of malnutrition, with a large, hard tumor in the tongue area that had invaded the entire base of the tongue, floor of the mouth and throat wall.

Previously, the patient had symptoms of prolonged pain and ulcers in the tongue area but subjectively did not go to the doctor, only going to the hospital when he could not eat or drink for 4-5 months, his body was severely malnourished.

The patient was consulted jointly by Viet Duc Friendship Hospital and the central ENT hospital with the image of a large, hard tumor in the tongue area, with almost no healthy part of the tongue left, causing difficulty in examination, eating and even anesthesia during surgery.

X-rays showed that the tumor had spread throughout the oral cavity, requiring the removal of the entire tongue, floor of the mouth, and neck lymph nodes to remove the cancerous lesion.

According to Dr. Bui Mai Anh, Department of Maxillofacial Surgery - Plastic and Cosmetic Surgery, Viet Duc Friendship Hospital, this is one of the rare severe and complicated cases. After removing the entire mass, it will create a large defect and lose important functional structures of the oral cavity, including the entire tongue, base of the tongue, side walls of the throat, and the entire floor of the mouth...

"Surgery is not just about removing the tumor, but doctors try to restore as much as possible the functions of eating, speaking, and swallowing - which are important functions related to the patient's quality of life.

We have planned very meticulously from anesthesia (endotracheal intubation, tracheostomy) to post-operative recovery in the context of the patient being malnourished, at high risk of infection, and slow wound healing," Dr. Mai Anh shared.

Thigh muscle-skin tongue reconstruction

After the tumor removal surgery, the doctors decided to reconstruct the entire tongue, floor of the mouth, and pharynx using a free flap taken from the thigh. It includes skin-muscle islands with motor nerve grafts for the tongue and skin and fat for the pharynx to partially restore the patient's function.

The surgery took over 10 hours, with small blood vessels and nerves being connected under a microscope. If the recovery process goes well, after a while, the tongue muscles will be able to move, allowing the patient to eat, swallow, and pronounce some simple words.

According to Dr. Mai Anh, oral cancer is currently ranked 3rd among head and neck cancers, with the characteristic of being easily overlooked in the early stages due to unclear symptoms.

In particular, the tongue and floor of the mouth are the intersection of the food and respiratory tracts, have a narrow anatomical structure, and are very difficult to shape when severely damaged.

Doctor Nguyen Hong Ha, head of the maxillofacial surgery - plastic and cosmetic department, Viet Duc Friendship Hospital, warned: "If you see prolonged ulcers, mouth pain, difficulty chewing, difficulty swallowing, voice changes... you need to see a specialist in ENT or maxillofacial surgery soon.

Many patients are subjective and only go to the doctor when their ability to eat is greatly affected. By then, the damage is too late and treatment is much more difficult and expensive.