The surgical removal of a part of the tongue or the entire tongue is called a glossectomy. A glossectomy may be partial (the removal of a part of the tongue), hemi (the removal of one side of the tongue), or total (the removal of the entire tongue). A glossectomy is performed in the following cases.
- Tongue cancer
- Mouth cancer
- Throat cancer
- Abnormal tongue enlargement
- Obstructive sleep apnea-blocking of your upper airway while you sleep
How is Glossectomy Surgery Performed?
For glossectomy surgery, general anesthesia will be given. A temporary opening in your neck to the windpipe will be made to enable you to breathe during the procedure. This is called a tracheostomy. If a partial glossectomy is being performed, your surgeon will remove the cancerous part of the tongue and stitch up the remaining tongue to ensure that there is no hole. In some cases, a small skin graft may be stitched into the place to fill the hole. A graft is a living tissue taken from another part of your body and transplanted to the required site. In the case of total glossectomy, the entire diseased tongue will be removed. A graft will be taken from either your forearm, thigh, or chest, to ensure that you are able to function post the surgery. This graft will serve as a new tongue for you. To ensure adequate blood flow to this new graft, blood vessels from the remaining parts of the tongue will be attached to the graft.
Preparation of Glossectomy Surgery
Preparation before a glossectomy is as follows:
- Investigations- Certain investigations like a physical examination, blood tests, tongue biopsy, and imaging tests like X-rays, CT scans, and MRI will be performed.
- Medications- Your doctor may advise you to stop certain medications like blood clotting medications one week prior to the surgery.
- Habits- To improve healing, avoid smoking and drinking for a few weeks before the surgery.
- Diet- In the weeks leading up to the surgery, try and build up your weight by consuming fruits, vegetables, and proteins. On the day before the surgery, you will have to consume a light meal. You will be required to fast after midnight before the surgery.
After theglossectomy surgery, you will be expected to follow up after one to two weeks to check your progress and healing. The results of your operation will also be discussed. Decisions on the requirement for further treatment options like radiotherapy (radiation) or chemotherapy will be advised by your doctor. Remember to bring a list of all the medications you have been taking to your follow-up visit. However, if you have any symptoms like fever, pain, shortness of breath, difficulty in swallowing, or worsening of symptoms, do not hesitate to contact your doctor before the follow-up date.
Risks For Glossectomy Surgery
The risks associated with a glossectomy are as follows:
- Bleeding of the tongue because of surgical intervention
- Infection- It is a post-surgery risk
- Blocked airway- If the tracheostomy gets blocked, this complication may occur.
- Salivary fistula- A fistula is a hole that may cause saliva to leak from the mouth into the neck.
- Swallowing problems- If there are issues with the graft, there will be difficulty in swallowing.
- Speech problems because of failure to adjust to the graft
- Failure of flap or reconstruction- If the flap or the transplanted skin does not get adequate blood supply, this complication may occur.
- Cancer recurrence- This complication is possible if some cancer cells remain behind.
Recovery From Glossectomy Surgery
Recovery after a glossectomy depends on which type of surgery you have had. After a 7–10-day hospital stay, you may be discharged from the hospital with a temporary or permanent feeding tube. This feeding tube will help meet your nutritional needs and enhance healing. Mouth care with gargles provided by your physician will be required to be performed after meals and at bedtime. The healthcare team will teach you how to take care of the surgical site to prevent infection. You will need to consume a diet instructed by your dietician (soft, bland, and not too hot or cold), and caring for your feeding tube will be provided. You will require speech and rehabilitative therapy to adjust to the new graft. You will need to avoid strenuous activities like bending, straining, lifting, and swimming for two weeks. Medications for pain relief and infection prevention will be prescribed. You will have to follow up with your doctor after two weeks of the surgery.
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