Surgical Procedures: Glossectomy

What is a glossectomy?

A glossectomy is surgery done to remove part or all of the tongue. It can be used to treat:

• Tongue Cancers.
• Some oral cavity (inside the mouth) cancers.
• Throat cancers.

The tongue’s jobs are to taste and help with swallowing, breathing, licking, and speaking. The tongue is about 3.1 to 3.3 inches in size. It is made up of two parts:

• The oral tongue- The front part of the tongue.
• The base of the tongue- Part of the throat (oropharynx), not the mouth.

This article goes over the removal of the oral tongue.

What are the types of glossectomy?

The types of glossectomy are:

• Partial glossectomy: Part of the tongue is removed.
• Hemi glossectomy: One side of the tongue is removed, leaving the other side intact.
• Total glossectomy: The whole tongue is removed. This causes an inability to swallow without getting food/liquids into the lungs (called aspiration). Because of this, a laryngectomy may also be done. Laryngectomy (removal of the larynx or voice box) helps prevent aspiration, but also causes loss of your voice. Reconstructive surgery is needed for this type of glossectomy.

Note: A temporary or permanent tracheostomy (procedure to create an opening in the neck to help air and oxygen reach the lungs) may be needed, depending on the surgery you had. Your care team will be able to talk to you about if you need one and for how long. Your provider will talk to you about the specifics of your surgery.

What are the risks of having a glossectomy?

As with any surgery, there are risks and possible side effects. These can be:

• Bleeding.
• Hematoma (A collection of blood that will go away on its own or may need to be treated with surgery).
• Infection.
• Salivary fistula (A hole causing saliva to leak from the mouth into the neck).
• Airway blockages (A blockage of the airway making it hard to breathe).
• Having a hard time swallowing (dysphagia).
• Aspiration (Food, fluid, or saliva is not swallowed properly and enters the lungs instead of the stomach).
• Pneumonia (Infection in the lungs).
• Weight loss.
• Having a hard time speaking (dysarthria)/loss of speech.
• Healing issues, such as flap or reconstruction failure.

Before surgery, your care team will talk to you about any other risks based on your health and the surgery you are having.

What is recovery like?

Recovery from a glossectomy depends on the type of surgery you had. Often, a 7-10 day hospital stay is needed. A temporary or permanent feeding tube may be needed for nutrition during and after the healing process.

You will be taught how to care for your incisions (cuts) and will be given any other instructions before leaving the hospital. Your provider will talk to you about changing your diet, how to care for your feeding tube and/or tracheostomy, as well as the need for rehabilitative and/or speech therapy.

Your care team will talk with you about the medications you will be taking, like those for pain, blood clot, infection, and constipation prevention, and/or other conditions.

Your provider will talk to you about changes in your activity level, which will depend on the surgery you had.

What will I need at home?

• Thermometer to check for fever, which can be a sign of infection. Your care team will tell you at what temperature you should call them.
• Wound, feeding tube, and tracheostomy stoma care supplies as needed.

When should I call my provider?

Your provider will give you details about when to call the office. You should call your provider if you have:

• Any signs of infection, such as fever, chills, swelling, bleeding, or mouth discharge.
• Choking.
• A hard time swallowing.
• An increase in pain that is not relieved with prescribed medications.
• Pain/swelling of the feet, calves, or legs.
• Shortness of breath, coughing, chest pain, and/or severe nausea/vomiting.
• Any new or worsening symptoms.

How can I care for myself?

You may need a family member or friend to help you with your daily tasks until you are feeling better. It may take some time before your team tells you that it is ok to go back to your normal activity.

Be sure to take your prescribed medications as you are told to prevent pain, infection, and/or constipation. Call your team with any new or worsening symptoms.

There are ways to manage constipation after your surgery. You can change your diet, drink more fluids, and take over-the-counter medications. Talk with your care team before taking any medications for constipation.

Taking deep breaths and resting can help manage pain, keep your lungs healthy after anesthesia, and promote good drainage of lymphatic fluid. Try to do deep breathing and relaxation exercises a few times a day in the first week, or when you notice you are extra tense.

• Example of a relaxation exercise: While sitting, close your eyes and take 5-10 slow deep breaths. Relax your muscles. Slowly roll your head and shoulders.

This article contains general information. Please be sure to talk to your care team about your specific plan and recovery.