A glossectomy removes part or all of the tongue to treat cancer or severe conditions. Reconstruction helps restore speech and swallowing. Learn how this surgery improves health and quality of life.
What is a Glossectomy?
A glossectomy is a surgical procedure to remove part or all of the tongue. It is typically performed to treat tongue cancer but may also be necessary for severe trauma, infections, or congenital conditions. The procedure can affect speech, swallowing, and taste, depending on the extent of the removal.
Why is a Glossectomy Needed?
A glossectomy is performed to treat conditions that severely affect the tongue. The most common reason is tongue cancer, especially when the tumor is large or has spread. Other reasons include:
● Severe tongue trauma or injury
● Extensive precancerous lesions
● Chronic infections or severe tissue damage
● Congenital abnormalities affecting function
The procedure helps remove diseased tissue and prevent further complications, improving survival and quality of life in certain cases. In some cases, a glossectomy procedure can treat obstructive sleep apnea and macroglossia (an enlarged tongue).
Often, tongue reconstructive surgery is needed after a glossectomy to restore function and appearance. Surgeons use tissue from other body parts, such as the forearm or thigh, to rebuild the tongue. This helps improve speech, swallowing, and overall quality of life. Rehabilitation, including speech and swallowing therapy, supports recovery and adaptation.
What are the Different Types of Glossectomy Surgeries?
There are several types of glossectomy, depending on how much of the tongue is removed:
● Partial Glossectomy: Removes a small portion of the tongue, usually for early-stage cancer or small lesions.
● Hemiglossectomy: Removes one side of the tongue while preserving the other half.
● Subtotal Glossectomy: Removes more than half of the tongue but not all of it.
● Total Glossectomy: Removes the entire tongue, usually for advanced cancer.
Reconstruction may be necessary to restore function, depending on the extent of the surgery.
Partial Glossectomy
A partial glossectomy removes a small portion of the tongue, usually to treat early-stage cancer or small lesions. Surgeons aim to preserve as much healthy tissue as possible to maintain speech and swallowing function. Depending on the amount removed, reconstruction may not be necessary. Recovery includes wound healing, speech therapy, and swallowing rehabilitation.
Hemiglossectomy
A hemiglossectomy removes one side of the tongue, usually to treat cancer. This procedure affects speech, swallowing, and tongue movement. Reconstruction using tissue from another part of the body may be needed to restore function. Patients often require speech and swallowing therapy after surgery. Recovery varies based on the extent of tissue removal and reconstruction.
Subtotal Glossectomy
A subtotal glossectomy removes more than half of the tongue but not all of it. This procedure is usually performed for extensive cancer. It significantly affects speech and swallowing. Reconstruction using tissue from another body part is often necessary to restore function. Patients need intensive speech and swallowing therapy to adapt and regain essential abilities.
Total Glossectomy
A total glossectomy removes the entire tongue, usually for advanced cancer. This procedure severely impacts speech, swallowing, and taste. Reconstruction with tissue grafts helps restore some function, but patients need alternative communication methods and a permanent feeding adjustment. Speech and swallowing therapy are essential for adapting to these changes and improving quality of life.
Glossectomy Surgery Procedure
The glossectomy procedure varies depending on the type and extent of tissue removal. However, the general steps include:
- Anesthesia: The patient receives general anesthesia to ensure they are unconscious and pain-free during surgery.
- Incision: The surgeon makes an incision in the tongue or the surrounding area, depending on the tumor's location.
- Tissue Removal: The affected part of the tongue is carefully removed. If cancer is present, the surgeon may also remove lymph nodes in the neck (neck dissection) to prevent the spread of cancer.
- Reconstruction: If a significant portion of the tongue is removed, reconstruction may be performed using tissue from another part of the body (flap surgery) to help restore function.
- Closure: The remaining tongue tissue is repositioned, and the incision is closed with sutures.
- Recovery and Monitoring: The patient is monitored in a hospital setting for complications, such as bleeding or breathing difficulties. A feeding tube may be required initially if swallowing is affected.
The complexity of the surgery depends on the amount of tissue removed and whether reconstruction is needed.
Recovery From a Glossectomy
Recovery from a glossectomy depends on the extent of the surgery. Patients require close monitoring and rehabilitation to regain essential functions like speech and swallowing. The recovery process includes:
Hospital Stay
Patients stay in the hospital for several days to weeks, depending on the surgery's complexity. Pain management, wound care, and infection prevention are essential during this period.
Breathing Support
Swelling after surgery may affect breathing. Some patients need a temporary tracheostomy (a tube in the neck) to help with breathing until swelling subsides.
Nutrition and Swallowing Therapy
● A feeding tube is often required initially, especially after a total or subtotal glossectomy, as swallowing may be difficult.
● A speech and swallowing therapist helps patients relearn how to eat and drink safely.
Speech Rehabilitation
● Speech may be affected, particularly after a hemiglossectomy or total glossectomy.
● A speech therapist assists in developing new ways to communicate. Some patients may need assistive communication devices.
Wound Healing and Follow-Up Care
● Regular wound care is necessary to prevent infection.
● Follow-up visits with the surgical and oncology team ensure proper healing and monitor for cancer recurrence if the surgery was for cancer treatment.
Long-Term Adjustments
● Patients may need ongoing therapy to improve speech and swallowing.
● Dietary changes, such as soft or liquid foods, may be necessary for some individuals.
● Psychological support can help patients cope with changes in speech and appearance.
● Attention to oral hygiene during recovery is important to reduce the risk of infection.
Recovery varies based on the type of glossectomy and individual health factors. Some patients regain near-normal function, while others may need lifelong adaptations.
Glossectomy Before and After
Before a glossectomy, patients may have difficulty speaking, eating, or experiencing pain due to cancer or other conditions. After surgery, recovery includes speech and swallowing therapy. Some patients adapt well, while others need assistive devices. Appearance and function change depending on the extent of removal. Rehabilitation helps improve quality of life over time.
Risks & Complications
Glossectomy is a complex surgery with potential risks. The procedure is generally safe when performed by experienced surgeons, but complications can occur.
Possible Risks and Complications
● Bleeding: Excessive bleeding during or after surgery may require medical intervention.
● Infection: Wound infections can delay healing and may need antibiotics.
● Swelling and Breathing Issues: Severe swelling may block the airway, requiring a temporary tracheostomy.
● Speech and Swallowing Difficulties: Loss of tongue tissue affects communication and eating. Therapy helps regain function.
● Aspiration Pneumonia: Difficulty swallowing may cause food or liquid to enter the lungs, leading to infections.
● Nerve Damage: Surgery may affect nerves controlling tongue movement and sensation.
● Scarring and Changes in Appearance: Reconstruction may be needed to improve function and appearance.
● Cancer Recurrence: If performed for cancer, there is a risk of recurrence, requiring further treatment.
Regular follow-up care and rehabilitation help manage complications and improve recovery.
How much does a glossectomy cost?
The cost of a glossectomy varies based on the country, hospital, surgeon’s expertise, and whether reconstruction is needed.
● In the US, the procedure can be very expensive, often costing tens of thousands of dollars.
● In the UK and Western Europe, prices are slightly lower but still high, especially in private hospitals.
● Turkey offers a more affordable option with world-class medical care. Many hospitals provide high-quality surgery, advanced technology, and experienced surgeons at a fraction of the cost compared to Western countries.
Frequently Asked Questions
What happens if you lose your tongue?
Losing your tongue affects speech, swallowing, and taste. Communication becomes difficult, but speech therapy and assistive devices help. Swallowing may require adjustments, including a feeding tube or diet changes. Reconstruction can restore some function. With therapy and support, many patients adapt to a new way of speaking and eating over time.
Can you survive without a tongue?
Yes, you can survive without a tongue. Breathing remains unaffected, but eating and speaking become challenging. A feeding tube may be necessary. Speech therapy and assistive devices help with communication. Tongue reconstruction can restore some function. With medical support and rehabilitation, many patients adapt and continue to live a fulfilling life.
Can you talk after a glossectomy?
Yes, but speech is affected, especially after a total glossectomy. Partial glossectomy patients may regain near-normal speech with therapy. Those without a tongue use alternative methods like speech devices or gestures. Reconstruction helps improve function. Speech therapy plays a key role in adapting and developing new communication techniques.
Can you taste after tongue removal?
Taste is affected after tongue removal, but some sensation may remain. The tongue has most taste buds, but the throat and palate also detect flavors. Partial glossectomy patients may still taste, while total removal greatly reduces it. Some patients adapt over time, relying on smell and texture to recognize foods.
What is the quality of life after a total glossectomy?
Quality of life changes after a total glossectomy, but adaptation is possible. Eating, speaking, and tasting become challenging. Patients use feeding tubes, speech devices, and therapy to adjust. Emotional support is important. With rehabilitation and assistive methods, many regain independence and lead fulfilling lives despite the adjustments.
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