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The Vallecular Line: An Objective Measure in Evaluating the Base of the Tongue and Vallecular Cancers for Transoral Robotic Surgery

Hai, Nabila MD,; Taheri, M. Reza MD, PhD; Sadeghi, Nader MD

Journal of Computer Assisted Tomography: September/October 2013 - Volume 37 - Issue 5 - p 686–693
doi: 10.1097/RCT.0b013e3182a0229a

Objective We hypothesized that the degree of the exophytic nature of the base of the tongue and vallecular cancers (BOTs) impacts the feasibility of transoral resection. The growth pattern of these cancers can be measured by the vallecular line (VL), which is the distance between the hyoid bone and the vallecular tip.

Materials and Methods The normal VL was measured by 3 radiologists on 50 magnetic resonance imaging scans. The VL was then measured on magnetic resonance imaging scans of patients with BOT cancers.

Results The mean VL was 8.2 mm (6.4–10 mm) in the healthy patients. The mean VL of the patients with predominantly exophytic BOT cancer was 22.7 mm (20.6–24.8 mm). Postoperative images of these patients demonstrate minimal loss of the native tongue after transoral resection.

Conclusions The VL is a valuable objective measurement of the exophytic nature of BOT cancers. Predominantly exophytic BOT cancers are deemed more amenable for successful and functional transoral surgical resection.

From the *Department of Radiology, and † Division of Otolaryngology-Head and Neck Surgery, The George Washington University Medical Center, Washington, DC.

Received for publication April 6, 2013; accepted June 10, 2013.

Reprints: Nader Sadeghi, MD, Division of Otolaryngology-Head and Neck Surgery, The George Washington University Medical Center, 2021 K St, NW, Suite 206, Washington, DC, 20006 (e-mail:

Presented at the Minimally Invasive Surgery Week hosted by the Society of Laparoendoscopic Surgeons, Minimally Invasive Robotic Association, and Society of Robotic Surgery Joint Annual Meeting and Endo Expo, September 5–8, 2012, Boston, MA.

The authors have no conflict of interest to disclose.

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.