The Effects of Glossectomy on Airway to Tongue Ratio and Mandibular Morphology Using MRI

Abstract

Purpose: This study asked if glossectomy surgery causes anatomical changes of the surrounding structures and the airway by altering the balance of forces in the oral cavity. We predict that glossectomy patients will have proportionately larger pharyngeal air spaces than controls relative to the hard and soft structures around the mandible.

Materials and Methods: Twenty subjects were studied, ten T1 or T2 SCC glossectomies and ten controls. The gathered MRI data sets were reconstructed into 3D volumes.

Results: Mid-sagittal transpalatal airway lengths were significantly shorter for the glossectomy subjects. All other measurements were not statistically significant between the two groups.

Discussion: A person may compensate for the reduction of tongue size following glossectomy, which may contribute to a shorter A-P airway distance at the transpalatal level. However, all other tests were not statistically significant, including the transpalatal area inidicating that objects in the oral cavity adapt to the reduction in tongue size and does not affect the established equilibrium. The overall transpalatal airway size may be maintained in post-glossectomy speakers by lateral expansion of the airway at the transpalatal level.

Conclusion: This study concluded that the spatial relationships between airway and oral structures may change in dimension, but not in balance of forces following glossectomy. Second conclusion was that a 3-dimensional imaging is required for evaluation of the airway.