eRadiograph Volume 7: Imaging of Oral Cavity | Page 17

bundle, require an anterior 2/3rd glossectomy. Lesions extending into the base
of tongue require a total glossectomy, and those extending to involve the pre
epiglottic fat/larynx require a laryngoglossectomy. An anterior 2/3rd or a total
glossectomy results in a significant loss of function and has a high morbidity. In these
situations radiation is instituted first.
Since occult metastases are common in N0 necks, most patients will also undergo a
radical neck dissection.
The TNM staging is the most used staging method.
T 0 -- No evidence of primary
T 1 -- Below 2 cm in greatest dimensiom
T 2 -- Between 2 and 4 cm
T 3 -- Greater than 4 cm
T 4 a -- Involvement of intrinsic/extrinsic muscles, cortical
bone, maxillary sinus, skin
T4b -- Involvement of masticator space, ptyergoid plates, skull
base or encasement of internal carotid artery.

Nodal Disease

N1 - Metastases in a single ipsilateral lymph node less than 3 cm in greatest
dimension
N2a - Metastases in a single ipsilateral lymph node between 3 and 6 cm in
greatest dimensions
N2b - Multiple ipsilateral lymph nodes less than 6 cm in greatest dimensions
N2c - Bilateral or contralateral lymph nodes none more than 6 cm in greatest
dimensions
N3- Metastases in a lymph node greater than 6 cm
M0- No distant metastases
M1- Distant metastases

17

Imaging of Oral Cavity

N0 - No nodal disease detected