[Wide excision in cancer of the tongue: the choice of approach, modalities of reconstruction].

Surgical treatment of extensive carcinoma of the tongue requires reconsideration at the present time: firstly, because the efficacy of other therapeutic measures is rapidly suppressed by the size of the tumors, and there is not theoretical reason for excluding extensive surgery, and secondly, because esthetic and functional sequelae of these bloody treatments have been totally modified by the introduction of new reconstructive techniques. Based on a series of 16 cases treated during a one-year period, the conditions for surgery of vast malignant tongue tumors (T3, T4, N indifferent) are analyzed, and findings emphasize the need for a wide approach. Clear exposure is obtained, the continuity of the mandibular arch is conserved, and effective anatomical and functional reconstruction obtained of tissues sacrificed by the musculocutaneous flaps.