Glossectomy is a surgery for the removal of total or a part of the tongue.
Glossectomy is always performed under general anesthesia.
A glossectomy is performed for the treatment cancer of the tongue. Removing the tongue is indicated if the patient has a cancer that does not respond to other forms of treatment.
Cancer of the tongue is considered very dangerous due to the reality that it can easily spread to nearby lymph glands. Most cancer specialists suggest surgical removal of the cancerous tissue.
A partial glossectomy is rather a simple surgery. The hole is normally repaired by sewing up the tongue immediately after the surgery or by using a small graft of skin, if the "hole" left by the removal of the cancer is small.
Care is taken to repair the tongue so as to maintain its mobility, if the glossectomy is more extensive.
Radial Forearm Free Flap
A general approach is to use a piece of skin taken from the wrist together with the blood vessels that supply it. This type of implant is called a radial forearm free flap. The flap is inserted into the hole in the tongue.
This process requires a highly skilled surgeon who is able to connect very small arteries.
Complete removal of the tongue, called a total glossectomy. Complete glossectomy is hardly performed.
Alcohol consumption and smoking are the most important risk factors for cancer of the tongue. The risk is notably higher in patients who use both alcohol and tobacco than in those who use only one.
Biopsy is the only way to confirm a diagnosis of cancer, if an area of abnormal tissue has been found in the mouth, either by the patient or by a dentist or doctor. If the biopsy indicates that cancer is present, a comprehensive physical examination of the patient's head and neck is performed prior to surgery.
A pathologist, who is a physician who specializes in the study of disease, examines the tissue sample under a microscope to check for cancer cells.
Post Glossectomy Care
After the performance of the glossectomy, patients usually remain in the hospital for 8 to 10 days. They often need oxygen in the first 24–48 hours after the surgery. Oxygen is administered through a facemask or through two small tubes placed in the nostrils.
Until the patient can accept taking food by mouth, he or she is given fluids through a tube that goes from the nose to the stomach. Radiation treatment is often scheduled after the surgery to demolish any remaining cancer cells. As patients regain the ability to eat and swallow, they also begin speech therapy.
Risk factors Of Glossectomy
Risk factors related with a glossectomy include:
- Fistula formation. Incomplete cure may result in the formation of a passage between the skin and the mouth cavity within the first two weeks following a glossectomy. This complication often happens after feeding has resumed. Patients who have had radiotherapy are at greater risk of developing a fistula.
- Poor speech and problem in swallowing. This complication depends on how much of the tongue is removed.
- Bleeding from the tongue. This is an early complication of surgery; it can result in severe inflammation leading to blockage of the airway.
- Flap failure. This complication is often due to problems with the flap's blood supply.
Results after Glossectomy surgery:
A successful glossectomy results in total removal of the cancer, better capability to swallow food, and restored speech. If at least one-third of the tongue remains and an experienced surgeon has performed the repair, the quality of the patient's speech is usually very good.
Total glossectomy results in severe disability because the "new tongue" is not capable of movement. This lack of movement creates much difficulty in eating and talking.
Even in the case of a successful glossectomy, the long-term result depends on the stage of the cancer and the connection of lymph glands in the neck. An alternative to glossectomy is the insertion of radioactive wires into the cancerous tissue. This is an efficient treatment but requires specialized surgical skills and facilities.