As a department specialising in catastrophic injuries, we regularly deal with people who have needed assistance from prosthetics. This is often in the form of a prosthetic limb but prosthetics can replace other types of missing body parts which have been lost due to trauma, disease or surgery or have been missing since birth. This includes maxillofacial prosthetics, which replace facial anatomy. 

There have been amazing advances in maxillofacial prosthetics in recent years, as demonstrated by the case of Dr Imogen Brooks, 30-year-old doctor, who, after treatment for tongue cancer, received a prosthetic tongue said to be the first of its kind in the UK, improving speech intelligibility and communication. 

Imogen was left without most of her tongue after surgery to remove the squamous cell carcinoma of the tongue, which is the most common type of head and neck cancer. Although the tongue was reconstructed, radiotherapy caused the reconstructed tissue to shrink, resulting in speech being so difficult for Imogen that she had to rely upon speech assistance technology.  

Imogen had researched possible treatments and had discovered about prosthetic tongues, which are an intra-oral maxillofacial prosthesis. She approached experts at Guy’s and St Thomas NHS Foundation Trust to develop a bespoke artificial tongue her and after months of research, scans and testing with her team, a final design was prepared which clips onto her lower teeth and is specifically moulded to fit her mouth. 

This has been a game changer for Imogen, who noticed an improvement in her speech within just 3 days; her speech improved to such an extent that she was able to pass an oral examination for her doctorate at King’s College London that would previously not have been possible for her.  

 While this story highlights the remarkable possibilities of rehabilitation, it also provides a useful springboard to examine clinical negligence risks and legal principles arising in head and neck cancer care across England and Wales. 

Head and Neck Cancer: Where Problems Can Arise 

Head and neck cancer care is complex, fast-moving, and multidisciplinary. Most teams deliver excellent care; however, when things go wrong, it is often due to system gaps, delays, or inadequate communication.  

Delayed Diagnosis and Referral 

Symptoms such as non‑healing mouth ulcers, persistent sore throat, tongue lesions, difficulty swallowing, unexplained lumps, or voice changes may need urgent referral on a two‑week pathway. Delay can affect treatment options and outcomes. 

Consent About Function and Alternatives 

Discussions should cover not only survival but day‑to‑day function: speech, swallowing, saliva control, taste, breathing, and appearance. Reasonable alternatives, including organ‑sparing options where appropriate, reconstruction choices, and the role of prosthetics, should be explained clearly. A prosthetic tongue, like other restorative advances, can help reclaim essential functions that define everyday living. The clinical team’s foresight, planning, and execution are key. 

MDT Coordination 

Head and neck cancer is typically managed by a multidisciplinary team (MDT) that may include surgeons, oncologists, radiologists, pathologists, speech and language therapists (SALT), dietitians, and restorative dentists or prosthodontists. Poor MDT communication or failure to escalate concerns can lead to missed opportunities. 

Surgery and Reconstruction Decisions 

The balance between cancer clearance and function is delicate. Decisions about partial or total glossectomy, flap reconstruction, or staged procedures should be documented and discussed in terms a patient can understand, with tailored risk information. 

Follow‑Up and Safety‑Netting 

Clear plans for post‑operative monitoring, pathology review, adjuvant therapy, and signs that should trigger urgent reassessment are essential. Missed or shortened follow‑up can delay identification of complications or recurrence. 

Rehabilitation and Long‑Term Support 

Early and sustained input from SALT, dietetics, and prosthodontics can be life‑changing. Where appropriate, timely referral for devices such as obturators or advanced prosthetics can improve speech and swallowing. Delays in rehabilitation reduce recovery potential and quality of life. 

What to Do if You Are Concerned 

If you have any concerns about the care you or a loved one have received surrounding head and neck cancer, please contact our clinical negligence team at Williamsons Solicitors who can explore how we may be able to assist. You may be able to pursue a claim for clinical negligence; although a claim does not change what happened, it could assist with securing much needed answers and acknowledgement as to any failings and with securing compensation to assist with rehabilitation.