Premier Hospital

What is Glossectomy ? Overview of the procedure

by Premier Hospitals | March 3, 2022 |

Our tongue plays an important role in our ability to speak and swallow, and proper tongue functions can positively influence our quality of life. However, the tongue is also susceptible to many conditions in which sometimes it needs to be expelled completely.  Glossectomy is one such procedure where the defective tongue is removed partially or completely. Generally, this procedure is used to treat tongue cancer and other cancer forms that affect or have affected the tongue, particularly the base of the tongue. The procedure is performed by oncology surgeons, who are experts in treating head, neck, and throat cancer. There are several aspects that make glossectomy (tongue removal) a complex procedure, including the tongue's high muscle density and the fact that it performs numerous functions related to digestion and speech. In order to retain the tongue's functionality as much as possible, the surgeon has to take all necessary precautions. To do so, surgeons ensure removing only the diseased part of the tongue, thereby reducing the chance of infection spreading. If the surgeon has to remove two-thirds of the tongue, reconstructive surgery must be performed following the procedure. Who Should Undergo the surgery Tongue cancer and certain types of oral cancers are two common reasons why a glossectomy is performed.  Tongue cancer is a form of oral cancer affecting the base of the tongue (the part close to the throat) or the oral. Even though tongue cancer comes in many forms, squamous cell carcinoma is the most common form. This form can also vary based on its origin. Tongue cancer is characterized by symptoms such as:
  • pain while swallowing
  • voice change (hoarse tone)
  • development of red or white color patches observed on the tongue
  • bleeding from the tongue
  • ulcerations.
In addition to tongue cancer, the tongue is also susceptible to oral cancers like throat, mouth, and lips cancers because the tongue is a part of the oral cavity. When tongue cancer is diagnosed in its early stages or if cancer has been isolated to a very small area of the tongue, a glossectomy may be the primary and only treatment option. However, if cancer spreads to other regions of the mouth and neck area, additional treatments such as chemotherapy and radiotherapy are often required. Depending on the procedure done, the outcome of the surgery can be different. For example, the patient may be able to retain speech, along with swallowing and food positioning abilities following a partial glossectomy. However, in the case of a total glossectomy, there may be severe restrictions on these activities even after attaching the tongue prosthesis. How Does the Procedure Work? In all cases, a tongue resection procedure is carried out in a hospital under general anesthesia. Based on where cancer or lesions are located, surgeons can take different approaches. For instance, when the cancer is located in the tongue, it can be surgically removed directly from the mouth. But, when the cancer is located at the base of the tongue, the surgeon may choose from laser microsurgery or Mandibulotomy. These are often called robot-assisted surgery, where the procedure uses robotic arms to keep the patient's mouth wide open during surgery. With the help of it, a surgeon is able to remove the cancerous part at the base more precisely.  The laser microsurgery relies on the use of a laryngoscope, a tube-like device that is placed in the larynx, which provides a view of the throat and even base of the tongue in real-time and eliminates the cancer lesions with lasers technology. On the other hand, Mandibulotomy is a much more complex procedure because an incision has to be made in the jaw so that the surgeon can have a clear view to operate on the tongue. A sample will be taken from the removed tongue for biopsy in order to determine whether cancer exists, and based on the outcome, the resection may continue until no cancer is found in the samples. Following removal of the tongue, the surgeon will reconstruct the tongue by attaching a prosthesis to the tongue or by using other flap techniques. It can take an hour or more for the surgery to be completed; then, the patient will be transferred to the recovery room. Usually, a feeding tube is inserted after the surgery and remains for a few days in most cases. Contact our specialist doctors at the premier hospital in Hyderabad for more detailed information. Call 040-23515100, +91-83747 18100 to book an appointment.