Glossectomy
Glossectomy is a surgical procedure to remove part of or all of the tongue to treat cancers of the tongue, some oral cavity and throat cancers.
Some facts about Glossectomy:
- The tongue is about 3.1 to 3.3 inches in size and it is used for tasting, swallowing, breathing, licking and speaking.
- The oral tongue and the base of the tongue are the two parts o the tongue.
- It is called as Partial glossectomy when part of the tongue is removed.
- One side of the tongue is removed, leaving the other side intact in Hemi glossectomy.
- The whole tongue is removed in case of Total glossectomy.
- The treatment of malignant and premalignant lesions of the oral tongue can be done by a Glossectomy.
- Tongue bleeding, Infection, Blocked airway, Swallowing problems, Inhaling food and fluids into the lungs, Problems speaking, Weight loss and Recurrence of cancer are possible complications from a Glossectomy.
- Failure of flap or reconstruction may occur when transplanted skin or flap does not get enough blood flow.
Preparation for Glossectomy:
- A physical exam, blood tests and biopsy of the tongue will be done prior to the procedure.
- Imaging tests such as X-rays, CT scan and MRI scan of the brain may also be conducted.
- Medications containing aspirin or ibuprofen (Advil, Motrin IB, others) should be before and after surgery as these medications may increase bleeding.
- Stop smoking if you smoke as smoking can increase your risk of having problems during and after surgery and also can slow the healing process.
- General anesthesia will be used before the surgery to put you to sleep during the surgery.
Procedure for Glossectomy:
- Glossectomy can be performed with multiple approaches including transoral glossectomy, glossectomy through lip-split mandibulotomy, and glossectomy through transcervical pull-through.
- Transoral glossectomy is the simplest of the three approaches in which the removal of tongue tissue is done through the mouth.
- The widest exposure is given by the lip-split mandibulotomy to access the tumor. But this is the most time-consuming procedure and carries more risk of complications.
- A sagittal osteotomy is performed in the lip-split mandibulotomy to splay open or swing the mandible open which allow inferior displacement of the tongue for a transoral-transcervical exposure of the posterior tongue and pharynx.
- Mandible reconstruction is needed after ablation is completed in this procedure.
- The tongue will be released into the neck through the floor of the mouth by opening the sublingual and submental compartments in case of glossectomy through transcervical pull-through.
- Inferior displacement of the tongue is provided for improved visualization of the posterior tongue.
- The exposure is less than the lip-split mandibulotomy approach due to the intact mandible.
- Mandibular reconstruction is not needed as sagittal osteotomy is not performed.
- The cancerous section will be removed and the rest of the tongue will be sewn so that there is no hole in a partial glossectomy.
- A small graft of skin is used sometimes to fill the hole. This skin graft will be stitched into place.
- The diseased tongue will be completely removed in a total glossectomy.
- A piece of skin will be removed from your wrist and will be placed in the hole left by the tongue.
- Blood vessels will also be attached from any remaining tongue to the graft to ensure blood flow.
- Tissue removed from the thigh, forearm, or chest can be used to make a new tongue.
- The lymph nodes in the neck will be removed in some cases.
Recovery from Glossectomy:
- The time it takes to recovery from a glossectomy depends on the type of surgery you have had. Usually, a 7 to 10 day hospital stay is needed.
- A temporary or permanent feeding tube may be required for nutrition, during and after the healing process.
- You may need a permanent feeding tube in your stomach if a total glossectomy is done
- Medication for pain, blood clot, infection, and constipation prevention, and/or other conditions will be discuss by your care team with you.
