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Glossectomy Overview

written by: Victoria Trix • edited by: Leigh A. Zaykoski • updated: 10/27/2009

A glossectomy is a surgery where part or all of the tongue is removed. This is normally done to treat cancer of the tongue in severe cases in which the cancer has not responded to all other forms of treatment available to the patient.

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    Procedure

    A glossectomy is a minor surgery that uses general anesthesia, and is considered a simple operation. Commonly with partial glossectomy procedures, the area left by the excising of cancer is small therefore it is repaired with stitches or a small skin graft so use can be continued. With extensive procedures, the tongue is repaired with grafts from the wrist as well as blood vessels of the wrist so that the tongue can be of use after the operation, called the radial forearm free flap. The total removal of the tongue is very rare. The surgery itself for excising the cancerous portion of the tongue takes minimal time, as most surgeons require only about an hour.

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    Pre-Surgery

    When abnormal tissues are found in the tongue, a biopsy has to be performed for cancer to be a diagnosis. Pathologists will then check the sample for cancerous cells. When present, the head and neck are then examined for further cancer cells.

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    Post Surgery

    Many patients will stay in the hospital for at least 7 days, as they will need oxygen for the first 2 days afterwards. This is done through a face mask, and fluids are given through a tube that is placed through the nose into the stomach. The tube is required until the patient can have food by mouth without pain. Radiation is then scheduled to kill remaining cancerous cells in the system. Speech therapy is normally needed to help the patient relearn how to swallow and eat.

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    Risks Associated with Glossectomy

    There are several risks associated with a glossectomy including the tongue bleeding. This can happen early on due to the surgery, and can result in swelling that leads to airway blockages. Bad speech and difficulty swallowing are often seen, depending on how much of the tongue has been excised. Formations of fistulas are the result of incomplete healing, and forms between the skin and the cavity of the mouth inside of the first 2 weeks after surgery, after eating by mouth has taken place. Flap failure is also a risk, where problems exist with the flap’s supply of blood in the new location.

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