This is very common in our part of the country. It can manifest as chronic non healing painful ulcer. Radiation of pain to the ear is ominous sign for a rapidly progressing ulcer. Tongue has a rich lymphatic supply which makes it notorious to spread rapidly. So management has to be early and aggressive. Depending on the size of lesion and the stage of disease management is determined by a cancer specialist.
Partial Glossectomy : For small lesion, wide local excision of tumor with a cuff of normal tissue. Primary closure is done.
Hemiglossectomy: larger tumor ,upto 50% of the tongue is sacrificed with option of reconstruction with free flaps.
Total Glossectomy: For locally advanced tumor, tumor crossing the midline .Reconstruction with pedicle of free flaps.
Lymph Node Dissection: Due to richness in lymphatic drainage, nodes have to be addressed atleast bythe supraomohyoid lymph node dissection (SOHND) or a modified neck dissection (MND) or a formal radical neck dissection.