Glossectomy

Glossectomy is the surgical removal of part or all of your tongue and surrounding tissue. It is done to treat cancer of the tongue. The surgical technique and the amount of tongue removed depends on the location and severity of the cancer, as well as the size of the tumors. If less than half of the tongue is removed, the procedure is called a partial glossectomy. If half of the tongue is removed, the procedure is called a hemiglossectomy. A total glossectomy is when more than two thirds of your tongue is removed.

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies to food or medicine.

  • Medicines taken, including vitamins, herbs, eyedrops, over-the-counter medicines, and creams.

  • Problems with anesthetics or numbing medicines.

  • History of bleeding problems or blood clots.

  • Previous surgery.

  • Other health problems, including diabetes and kidney problems.

  • Possibility of pregnancy, if this applies.

  • History of tobacco use.

RISKS AND COMPLICATIONS

Complications associated with glossectomy may include:

  • Damage to surrounding nerves, tissues, or structures.

  • Airway blockage from swelling and bleeding.

  • Difficulty swallowing or eating.

  • Collection of fluid in your mouth.

  • Difficulty speaking.

  • Unintended weight loss.

  • Failure of the graft to attach at the new site.

  • Allergic reaction to the anesthetic.

  • Infection.

  • Formation of a hole (fistula) between your mouth and the skin of your neck. This can happen if your sutures open before your wound heals.

BEFORE THE PROCEDURE

  • Your caregiver may have the following exams and tests done:

  • Physical exam.

  • Blood tests.

  • Urine tests.

  • Imaging exams.

  • Ask your caregiver about changing or stopping your regular medicines. You may need to stop taking blood thinning medicines or aspirin. Your caregiver also may have you take certain medications before your procedure, such as antibiotic medicine, to prevent infection.

  • Stop smoking if you smoke. Smoking increases the time it takes to heal after surgery.

  • Dental fluoride treatments and removal of unhealthy teeth are often necessary before the procedure. This is done to help ensure that you heal properly.

PROCEDURE

An intravenous (IV) tube is inserted with a needle into a vein in your arm or hand. Fluids and medicines flow into your body through the IV tube. Your caregiver will use a scalpel, laser, or hot knife to remove the cancerous area of the tongue and surrounding tissue (excision).

If a very large section of your tongue is removed, it may be necessary to split your lip and jaw to control bleeding and avoid injury to vital structures. Also during a large excision, a breathing tube may be inserted through your neck and into your windpipe (trachea). This tube is called a tracheostomy tube. The tracheostomy tube is temporary and helps you breath during and after surgery. The tracheostomy tube is removed once there is no more swelling in your airway from the surgery.

The wound on your tongue is usually sewn together with stiches (sutures) after a partial glossectomy. However, for larger excisions, skin and muscle from other parts of your body (grafts) are often used to fill the area that was removed. The graft is also used to cover the floor of your mouth. The floor of your mouth must stay closed to prevent saliva from draining into your neck. A feeding tube may be inserted through the skin of your abdomen and into your stomach to feed you, if it is anticipated that you will have trouble swallowing for an extended period after surgery. The feeding tube will be removed once you are able to swallow again.

AFTER THE PROCEDURE

  • You may be required to stay in the hospital for as long as 10 days (2 to 3 days for a partial glossectomy and 7 to 10 days for a total glossectomy).

  • The area from where the skin grafts are taken (donor sites) will be bandaged with dressings.

  • Your tracheostomy tube and your mouth will be suctioned regularly to remove excess fluid.

  • You may have drainage tubes extending from your mouth or neck.

  • If you have a feeding tube, you will be fed through the tube once your bowels are working well.

  • At first, you will be given a writing board to communicate, and then you will be taught how to speak by a speech therapist.