What are the more effective examination methods for tongue cancer?

What are the more effective examination methods for tongue cancer? The symptoms of tongue cancer are actually quite obvious, but they are easily ignored by patients because the early symptom of tongue cancer is oral ulcers. If oral ulcers persist for a long time and are relatively large in area, it is necessary to consider the possibility of tongue cancer. So what are the effective examination methods for tongue cancer?

(I) Key points of medical history collection

High-risk areas of the tongue: ulcers and neoplasms that do not heal for a long time on the edge, tip, back or belly of the tongue, which may be accompanied by a history of local white or erythema or chronic irritation factors such as residual tongue crown.

The tumor grows rapidly and causes pain, limiting tongue movement and making eating and swallowing difficult.

Whether there is a tumor on the same or opposite side of the neck.

History of smoking, alcoholism, betel nut chewing, patient age, gender, and tumor history.

(B) Physical examination

1. Local inspection

Visual and palpation of the color, shape, and texture of the tongue mucosa: Focus on high-risk areas, such as the edge, tip, and belly of the tongue. Chronic irritants often exist in the corresponding areas of the tumor, such as residual roots, residual crowns, or poor restorations. Precancerous lesions such as white spots may also exist.

It is usually an ulcerative or infiltrative tumor with hard texture, unclear borders and tenderness. The pain is obvious and can radiate to the ear and temporal region and half of the head and face. When the tumor infiltrates the lingual nerve and hypoglossal nerve, there may be tongue numbness and tongue movement disorders. Difficulty in speaking, eating and swallowing may occur. Whether there is secondary infection. The scope of the tumor should be determined: whether there is infiltration growth, whether the lesion is unilateral or crosses the middle chin, and whether it invades the root of the tongue, floor of the mouth, gums, mandible and other adjacent tissue areas. Record the size of the lesion and calculate the volume of the tumor.

Neck examination: Because the tongue has abundant lymphatic vessels and blood circulation, and the tongue has frequent mechanical movements, tongue cancer metastasizes earlier and has a higher chance of metastasis. Therefore, it is necessary to pay attention to a detailed physical examination of the entire neck to avoid omissions. The metastasis of tongue cancer to the neck generally follows a step-by-step metastasis pattern. The examination of sentinel lymph nodes is particularly important, with the deep upper cervical lymph nodes being the most common. However, the "jump" metastasis of the tumor cannot be ignored.

Cancers in the front of the tongue often metastasize to the submandibular and upper and middle groups of deep cervical lymph nodes. Cancers in the tip of the tongue can metastasize to the submental or deep cervical lymph nodes. Cancers in the base of the tongue may metastasize not only to the submandibular or deep cervical lymph nodes, but also to the lymph nodes behind the styloid process and the posterior pharynx. Cancers in the dorsum of the tongue or across the midline of the tongue may metastasize to the contralateral cervical lymph nodes.

2. Full body examination

Check and record the patient's body position, mental state, nutritional status, body temperature, heart rate, blood pressure, etc. Patients with advanced tongue cancer may experience anemia, weight loss and other symptoms. If coughing, hemoptysis, chest pain occur, the possibility of lung metastasis should be considered. In addition to general routine physical examination items, the focus should be on checking the tissue flaps that may need to be transplanted to repair the defect after tongue cancer surgery: such as the pectoralis major muscle, forearm, etc.

Evaluate the various conditions of the donor site that affect the repair effect, such as skin color, subcutaneous tissue, muscle mass, blood supply, and the effect of donor site flap removal on appearance and function. Record the patient's height and weight. Calculate their body surface area to facilitate accurate dosing during chemotherapy.