Glossectomy

Why is this procedure done?

Glossectomy is a surgery used to remove all or part of the tongue. It is often done to treat cancer of the tongue. The tongue or part of it is removed if cancer does not respond to other treatments. ‚
There are many types of surgery that can be done. Your doctor will decide how much of the tongue has been affected and what part needs to be removed. The surgery may remove: ‚

Part of the tongue. This is a partial glossectomy.
One side of the tongue. This is a hemi-glossectomy.
The whole tongue. This is a total glossectomy.

What will the results be?

Most often, the cancer is removed. ‚

What happens before the procedure?

Your doctor will take your history. Talk to the doctor about: ‚

All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor if you have any drug allergy. Bring a list of drugs you take with you.
Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
When you need to stop eating or drinking before your procedure.
Your doctor will do an exam of your head and neck and may order:
- Lab tests
- X-rays
- CT scans
- A sample of your tongue. This is a biopsy.
You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.

What happens during the procedure?

Once you are in the operating room, you will be given a drug to make you sleepy. It will also help you stay pain free during the surgery. The staff will put an I.V. in your arm to give you fluids and drugs.
While you are going to sleep, your doctor will put an oxygen mask on your face to give you more oxygen.
Your doctor will put a small tube in your nose. This tube goes down to your stomach to keep it drained during surgery. You will have a tube in your bladder to drain urine.
Your doctor will remove the affected part or all of your tongue. If part of the tongue is affected, your doctor will remove the cancer cells and close the cut with stitches. Sometimes, a small piece of skin from another part of your body is used to fill the hole.
If a large part or all of the tongue is removed, a skin flap is made. Your doctor will take a piece of skin, most often from the wrists, to replace the removed tongue. Your doctor will place the flap into the hole where the tongue is taken.
If you are having a flap, you may have a hole cut into neck and windpipe or trachea to help you breathe. This is a tracheostomy. This will be taken out later.
Sometimes, your doctor will place a feeding tube during the surgery. The doctor places the tube through the belly with a very small cut. The tube will give you liquid food while you are healing because your mouth will be too swollen to eat and drink.
Based on the surgery, you may need to spend time in the hospital, or you may go home after the procedure. Your doctor will talk about this with you before the surgery.
The procedure may take a few hours based on the type of surgery you had.

What happens after the procedure?

Based on the amount of surgery that is needed, you may have to stay in the Intensive Care Unit (ICU) for the first 24 to 48 hours to recover after surgery. The staff will watch you closely. Your doctor may give you drugs for pain through your I.V. Sometimes, the breathing tube is kept in after the surgery. While the tube is in place, you will get I.V. drugs that keep you sleepy and comfortable. The staff will take out your breathing tube when you are awake and strong enough to breathe on your own.
You will have trouble taking foods by mouth. The tube in your nose will be left in place for a few days. You will be fed through the tube directly into your stomach. The doctor will take the feeding tube out when you are able to take enough food by mouth. Then, you will slowly start eating again.
Within a day or two, you will get out of bed to a chair. The staff will help you begin to walk around. Doing coughing and deep breathing exercises will help keep your lungs clear and keep you from getting pneumonia.
You may have trouble talking in the first few days when your mouth and face are swollen. You may find it easier to communicate with other people by:
- Writing on a piece of paper
- Using gestures or lip reading
- Using a dry erase board or picture board
You may need to stay in the hospital for a period of time while healing.
Your doctor may have you see a speech therapist before and after the surgery. A change in your mouth causes a change in speech, how you communicate, and how you swallow.

What care is needed at home?

Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
Take all your drugs as ordered by your doctor.
Practice good oral hygiene and hand washing. Gargle a few times a day to help prevent infection.
Talk slowly so that you do not slur your words and to avoid drooling.
Ask your doctor about any wound care you may need.
Your doctor will talk with you about your diet. It may be hard to swallow or speak for a while. Eat soft foods that are easy to swallow.

What follow-up care is needed?

Your condition needs close monitoring. Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
You may need to see a speech therapist for your speech and if you have swallowing problems.
You may need to see a dietician. Ask about proper nutrition to meet your dietary needs. Your therapist and dietician will help you decide what foods and drinks are best for you.
In some cases, you may need to have radiotherapy or radiation to clear up any remaining cancer. Your doctor will tell you when you need to have this follow-up treatment.

What lifestyle changes are needed?

Avoid smoking and beer, wine, and mixed drinks (alcohol).
Eat a healthy diet. A well-balanced diet may help to lower the risk of cancer.
Be active. Exercise can help reduce fatigue and low mood. If you feel tired, balance your activity with rest. Ask your doctor for an exercise plan that is right for you.

What problems could happen?

Infection
Numbness of the tongue
Changes in taste
Trouble talking, swallowing, or eating
Weight loss
Poor healing
Fistula formation
Cancer may come back
Need for more surgeries

Where can I learn more?

American Cancer Society ‚
http://www.cancer.org/Cancer/OralCavityandOropharyngealCancer/DetailedGuide/oral-cavity-and-oropharyngeal-cancer-treating-by-stage ‚
Cancer Treatment Centers of America ‚
http://www.cancercenter.com/oral-cancer/oral-cancer-surgery-side-effects.cfm ‚

Consumer Information Use and Disclaimer

This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚

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