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March 1959

Reconstruction with Loss of the Hyomandibular Complex in Excision of Large Cancers

Author Affiliations

From the Division of Plastic Surgery, The Johns Hopkins Hospital and The Johns Hopkins University School of Medicine.

AMA Arch Surg. 1959;78(3):425-436. doi:10.1001/archsurg.1959.04320030069013

Surgeons treating large cancers of the head and neck find that tumors in two locations present particularly formidable problems. One of these areas is the base of the tongue, where large neoplasms are difficult to remove without sacrifice of the essential blood supply to both sides of the tongue. This results usually in total glossectomy and must often be followed by removal of the larynx, even though this important structure be entirely free of tumor. If laryngectomy is not performed, the patient may succumb to aspiration pneumonia, due to inability to keep food and saliva out of the trachea in the absence of a tongue.

A second particularly troublesome tumor is one that involves the symphysis of the mandible and related muscles supporting the hyoid bone, larynx, and tongue. Removal of this important functional unit may leave the patient unable to breathe by way of the larynx and unable to