Glossectomy
(Partial Glossectomy; Total Glossectomy; Hemiglossectomy)
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
This surgery is used to treat tongue cancer when other treatments don't work.
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Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review possible problems such as:
- Tongue bleeding
- Infection
- Blocked airway
- Swallowing problems
- Inhaling food and fluids into the lungs
- Problems speaking
- Weight loss
- Failure of flap or reconstruction—occurs when transplanted skin or flap does not get enough blood flow
- Recurrence of cancer
Your chances of problems may be higher for:
What to Expect
Prior to Procedure
Your doctor may do the following:
- A physical exam
- Blood tests
- Biopsy of the tongue—a sample of the tongue is taken and examined under a microscope
- Imaging tests such as:
Leading up to the surgery:
- Talk to your doctor about your medicines. You may be asked to stop taking some up to 1 week in advance.
- Arrange for a ride a ride home.
- 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 make changes to your medicines.
Anesthesia
General anesthesia will be used. You will be asleep.
Description of the Procedure
A tracheotomy will allow you to breathe during and after surgery. This is an opening from the outside of your neck to your windpipe. A tube is placed into the opening so you can breathe. It's usually temporary.
For a partial, the doctor will remove the cancerous section. The rest of the tongue will be sewn so that there is no hole. Sometimes, a small graft of skin is used to fill the hole. This skin graft is stitched into place.
A total is more complex. 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.
Sometimes, a new tongue can be made from tissue removed from the thigh, forearm, or chest.
The lymph nodes in the neck may be removed in some people.
How Long Will It Take?
Several hours
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Medicines will ease pain afterwards.
Average Hospital Stay
7-10 days
Post-procedure Care
At the Hospital
You may have:
- Supplemental oxygen for the first 1-2 days
- IV fluids and medicines.
- Special boots or socks to help prevent blood clots.
- You will need to get out of bed and move around as soon as possible.
- To breathe deeply and cough many 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.
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 healthcare staff will take steps to lower your chances of infection such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to lower your chances of infection such as:
- Washing your hands often and reminding your healthcare staff to do the same
- Reminding your healthcare staff to wear gloves or masks
- Not allowing others to touch your incision
At Home
You will need to continue working with a speech and therapist. Your doctor may advise self-care measures and medicines to ease discomfort or prevent infection. Work with a dietitian to come up with a meal plan that works with your situation.
Call Your Doctor
Call your doctor if any of these occur:
- Fever or chills
- Swallowing problems
- You choke on food or liquids
- Swelling, excess bleeding, or pus from mouth
- Pain or swelling in the feet, calves, or legs
- Coughing, breathing problems, or chest pain
- Nausea or vomiting
If you think you have an emergency, call for emergency medical services right away.
RESOURCES:
National Cancer Institute
https://www.cancer.gov
The Oral Cancer Foundation
https://oralcancerfoundation.org
REFERENCES:
Dziegielewski PT, Ho ML, Rieger J, et al. Total glossectomy with laryngeal preservation and free flap reconstruction: Objective functional outcomes and systematic review of the literature. Laryngoscope. 2013;123(1):140-145.
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—patient version. National Cancer Institute website. Available at: https://www.cancer.gov/types/head-and-neck. Accessed July 2, 2018.
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.
Lip and oral cavity cancer treatment (adult). National Cancer Institute website. Available at: https://www.cancer.gov/types/head-and-neck/patient/adult/lip-mouth-treatment-pdq. Updated June 28, 2018. Accessed July 2, 2018.
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: https://oralcancerfoundation.org/treatment/surgery. Accessed July 2, 2018.
Treatment of head and neck cancer. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T901119/Treatment-of-head-and-neck-cancer. Updated January 26, 2018. Accessed July 2, 2018.
Last reviewed May 2018 by EBSCO Medical Review Board Donald W. Buck II, MD Last Updated: 7/2/2018