(Partial Glossectomy; Total Glossectomy; Hemiglossectomy)
Definition
Definition
A glossectomy is the surgical removal of the tongue. The surgery may be:
- Partial—removal of part of the tongue
- Hemi—one side of the tongue is removed
- Total—removal of the whole tongue
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Reasons for Procedure
Reasons for Procedure
This surgery is used to treat tongue cancer when other treatments have not been successful.
Tongue CancerCopyright © Nucleus Medical Media, Inc.
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Possible Complications
Possible Complications
Problems from the procedure occur, but all procedures have some risk. Your doctor will review potential problems, like:
- Tongue bleeding
- Infection
- Airway blockage from swelling and bleeding
- Trouble swallowing or eating and aspiration of liquids
- Difficulty with speech or inability to speak
- Weight loss
- Failure of flap or reconstruction—occurs when transplanted skin or flap does not get enough blood flow
- Recurrence of cancer
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:
What to Expect
What to Expect
Prior to Procedure
Your doctor may do the following:
- Ask about your medical history, including whether you smoke or drink alcohol
- Physical exam
- Blood work
- Biopsy of the tongue—a piece of tongue is removed and sent to a lab for testing to diagnose cancer
- Pictures of structures inside the body may be taken
Leading up to the surgery:
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
- Arrange for a ride to and from the hospital.
- Eat a light meal the night before. Do not eat or drink anything after midnight.
- If you have diabetes, ask your doctor if you need to adjust your medications.
Anesthesia
General anesthesia will be used. You will be asleep during the procedure.
Description of the Procedure
You will have a tracheotomy to allow you to breathe during and after surgery. This creates an opening from the outside of your neck to your windpipe. A tube is inserted through the opening to allow for air flow. It is usually temporary.
If part of the tongue needs to be removed, the doctor will remove this cancerous section. The remaining area of the tongue will be sewn so that there is no hole. Sometimes, a small graft of skin will be used to fill the hole. This skin graft will then be sewn into place.
If the entire tongue needs to be removed, this is a more complicated surgery. The doctor will remove the diseased tongue. A piece of skin from your wrist will also be removed. This skin graft will be placed in the hole left by the tongue. Blood vessels will also be attached from any remaining tongue to the graft. This is to ensure blood flow.
Occasionally a new tongue will be constructed from tissue removed from the thigh, forearm, or chest.
Sometimes the lymph nodes in the neck will also need to be removed.
How Long Will It Take?
Several hours
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay
7-10 days
Post-procedure Care
At the Hospital
While recovering at the hospital, you may receive the following care:
- Supplemental oxygen for the first 1-2 days
- Fluids and medications will be given through an IV.
- Special boots or socks to help prevent blood clots—You will also be encouraged to get out of bed as soon as possible.
- Instructions to breathe deeply and cough 10-20 times every hour for the first few days—This will decrease the risk of pneumonia.
- Nutrition through a tube—When you are able to swallow, you will be able to have drinks and pureed food. If a total glossectomy is done, you may need a permanent feeding tube in your stomach.
In addition, your doctor may have you:
- Work with a speech therapist to learn to speak and swallow after surgery
- Begin radiation therapy to treat the cancer if it had not been given before
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as:
- Washing your hands often and reminding your healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incision
At Home
When you return home, do the following to help ensure a smooth recovery:
- Gargle several times a day to prevent infection.
- Take antibiotics as prescribed.
- Take pain medication to ease discomfort.
- Slowly resume your normal diet if you are able to swallow effectively.
- Continue to work with a speech therapist.
Call Your Doctor
Call Your Doctor
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
- Signs of infection, including fever and chills
- Difficulty swallowing or choking on food or liquids
- Swelling, excessive bleeding, or discharge from mouth
- Pain and/or swelling in the feet, calves, or legs
- Cough, shortness of breath, chest pain, or severe nausea or vomiting
- Increased pain
- New or worsening symptoms
If you think you have an emergency, call for medical help right away.
RESOURCES:
Oral Cancer Foundation http://www.oralcancerfoundation.org
CANADIAN RESOURCES:
References:
Fujimoto Y, Hasegawa Y, Yamada H, Ando A, Nakashima T. Swallowing function following extensive resection of oral or oropharyngeal cancer with laryngeal suspension and cricopharyngeal myotomy. Laryngocope. 2007;117(8):1343-1348.
Head and neck cancer. National Cancer Institute website. Available at:
http://www.cancer.gov/types/head-and-neck
Accessed May 23, 2014.
Kimata Y, Uchiyama K, Ebihara S, et al. Postoperative complications and functional results after total glossectomy with microvascular reconstruction. Plast Reconstr Surg. 2000;106(5):1028-1035.
Mehta S, Sarkar S, Kavarana N, Bhathena H, Mehta A. Complications of the pectoralis major myocutaneous flap in the oral cavity: a prospective evaluation of 220 cases. Plastic Reconstruc Surg. 1996;98(1):31-37.
Surgery. Oral Cancer Foundation website. Available at:
http://www.oralcancerfoundation.org/treatment/surgery.php
Accessed May 23, 2014.
What you need to know about oral cancer, treatment. National Cancer Institute website. Available at:
http://www.cancer.gov/publications/patient-education/wyntk-oral-cancer
Accessed May 23, 2014.
Last Updated: 5/23/2014