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'Beavertail' Surgery Helps Tongue Cancer Patients

in the University of Alberta faculties of Medicine and Dentistry, and Rehabilitation Medicine, as well as the Misericordia Hospital in Edmonton, Canada. O'Connell presented their findings at the international meeting of the annual American Head and Neck Society in Chicago earlier this year, where the study won the title of Best Resident Clinical Research Award.

The beavertail modification meant that 95 per cent of the 20 patients who completed the study (there were 36 originally) were able to swallow successfully after one year of tongue reconstruction. Only one patient still had problems with swallowing.

The surgery involves removing the cancerous tissue and replacing it with a healthy paddle of skin and connective tissue with artery intact, and connecting it to healthy blood vessels in the neck. The beavertail of fat that comes with the skin is connected to the base of the tongue to add bulk, and tolled upon itself, much like a jellyroll. The tongue is crucial to the swallowing process; the base of a healthy tongue acts as a piston that pushes food down the throat. With surgery, the reconstructed tongue instead acts as a buttress, which squeezes the food into the esophagus.

There are about 900 cases of cancer of the base of tongue or tonsils diagnosed in Canada each year, and while that accounts for just one per cent of all cancers in North America, doctors are seeing a disturbing trend. The cancer is attributed to smoking and alcohol consumption, but the fastest-growing group of new cases involves people who don't have those risk factors. 'It's not an epidemic, but it is scary when you realize you can do everything right and still be saddled with this condition,' O'Connell noted.

The research team hopes the study's findings will convince other doctors treating patients with base of tongue cancers that primary surgery followed by radiation gives them the best chance at swallowing after their treatment.

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