We evaluated clinicopathological factors in 83 patients with atypical epithelium (AE) around squamous cell carcinomas of the tongue, who were selected from 128 patients (65%; 83/128) with primary Stage I or II carcinomas who underwent local resection without biopsy in our department from 1975 to 2005.
Lesions were re-evaluated by pathological diagnosis of the resected specimen, using the General Rules for Clinical and Pathological Studies on Oral Cancer (1st ed., 2010), and included 35 oral intraepithelial neoplasias (OIN) and 48 oral epithelial dysplasias (OED). Of the 83 cases, 54 (21 OINs, 32 OEDs and a specimen that could not be classified) had AE on their surgical margins. Of these, 22.9% (19/83) recurred and 27.8% (15/54) had recurrence of AE-positive mucosal margins, including 42.9% (9/21) of the OIN cases and 18.8% (6/32) of the OED cases. Mean duration from resection to recurrence was significantly shorter for OIN at 10 months (range: 3-33 months) than for OED at 57 months (range: 46-70 months; P = 0.0015).
We concluded that classifying AE into OIN or OED using the General Rules for Clinical and Pathological Studies on Oral Cancer is helpful in assessing risk of progression to invasive carcinoma, and that OIN should be treated as soon as possible because of its tendency to recur.

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In this study, we analyzed the chronological change of speech function during a five-year period in myocutaneous flap volume and tongue movement of a patient with subtotal glossectomy using intraoral inspection, speech intelligibility test and ultrasonographic examination.
A 50-year-old male with diagnosis of tongue cancer classified as T3N0M0 received neoadjuvant radiotherapy, subtotal glossectomy, modified neck dissection, and reconstruction using a rectus abdominis myocutaneous flap. The postoperative course of the patient was uneventful. However, speech therapy was provided for this patient since he complained of speech difficulties. A tongue function examination including speech intelligibility test was performed at 4 months, 1 year 2 months, 2 years 5 months and 5 years 4 months post-operatively. Tongue movement was observed with ultrasonography at 2 years 5 months and 5 years 4 months post-operatively.
As a result, although a reduction in the volume of the myocutaneous flap was obvious, the total speech intelligibility improved at 1 year 2 months compared to 4 months post-operatively, and the improvement was maintained. The intelligibility of the anterior tongue sounds worsened, but the intelligibility of the posterior tongue sounds improved over time. As ultrasonographic findings, reduction in flap volume, disappearance of unstable movement, decrease in tongue movement during vowel production and increase in upward and forward tongue movement were observed at 5 years 4 months compared to 2 years 5 months.
These results suggest that despite the decrease in flap volume, the speech intelligibility was improved and maintained stably by acquisition of approximately normal speech function.

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