A glossectomy is the surgical removal of a part or all of the tongue. Surgeons commonly perform glossectomy to treat tongue cancer. The procedure requires general anesthesia and possibly recovery in a hospital setting.

The extent of the surgery can depend on the size and stage of the tumor. After glossectomy, a doctor may perform reconstructive surgery to help restore the appearance of the affected areas.

Glossectomy may affect a person’s ability to eat and speak. To relearn these functions, recovery may involve speech therapy, sometimes in combination with other therapies.

This article looks at what glossectomy is, including the types and associated risks. It also explains what happens before, during, and after the procedure.

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Glossectomy refers to a group of surgical procedures in which a surgeon removes a portion or all of the tongue. Doctors usually recommend the surgery to remove malignant or premalignant tongue tumors. It may also be a treatment option in some cases of macroglossia (enlarged tongue) and obstructive sleep apnea.

The extent of the surgery will depend on how large the tumor is and whether it is advanced.

Types of glossectomy are as follows.

Partial glossectomy

A surgeon may perform a partial glossectomy to remove a small tongue tumor. The procedure involves a surgeon removing a small portion of the tongue. The affected area may heal on its own or require minor reconstruction.

Subtotal glossectomy

Larger tongue tumors may require a subtotal glossectomy, in which a surgeon removes a more significant portion of the tongue.

A person may require reconstruction to optimize their ability to swallow and speak after the surgery.

Total glossectomy

If a person has an advanced tumor in the tongue, a surgeon may remove the entire tongue. A person may also need further surgery if the cancer has spread to surrounding structures, for example, a laryngectomy for cancer affecting the larynx (voice box).

The risks of a glossectomy include those associated with most head and neck surgical procedures and some more specific ones.

Risks and complications of a glossectomy may include:

Before a glossectomy, doctors will perform examinations and tests to determine whether a person is generally well enough to undergo surgery.

This typically includes a physical examination and other tests, such as:

To prepare for the surgery, a doctor will assess a person’s clinical history and ask questions about past treatment. This can help them plan the procedure to be as safe and effective as possible.

Determining the extent of the tumor and creating an airway plan beforehand is also vital. Knowing this information can help doctors plan or adjust the surgery accordingly.

A doctor will examine the tumor and the nearby structures, including the larynx, soft palate, and floor of the mouth. Imaging techniques such as a flexible laryngoscopy help assess whether a tumor has extended to areas beyond the tongue.

Airway plans can assess whether a person requires nasal intubation so that the breathing tube does not block the area the surgeon will operate on.

Ultimately, a doctor will tell a person what to expect on the day and how best to prepare.

A person will receive general anesthetic before the operation begins.

Depending on the size, location, and tumor advancement, surgeons may use the following approaches:

  • Transoral glossectomy: Surgeons remove a tumor through the mouth if it is small or shallow. They may stitch the incision closed or leave it to heal naturally. For larger incisions, they may use flaps to reconstruct the area. This involves removing tissue from another body part and connecting it to the tongue.
  • Lip-split mandibulotomy: For this approach, surgeons will remove a part or all of the lower jaw bone and make an incision through the lips to expose the tongue. This provides access to remove the tumor and, possibly, the lymph nodes in the neck. Before closing the wounds, surgeons typically reconstruct the tongue with flaps and bone grafts from other body areas.
  • Transcervical pull-through: Surgeons may remove tongue tumors by creating an opening in the neck to reach the area. They may then perform reconstruction on the soft tissue.

Following a glossectomy, a person may have a breathing tube in their neck or nasal cavity. They may also have tubes for feeding and fluid drainage.

A person typically cannot eat for a few days after the surgery. The healthcare team responsible for their care will advise them on how to get adequate nutrition and any dietary changes during this time.

Depending on the extent of the surgery, some people may experience difficulty speaking and swallowing. Some individuals may require rehabilitation or further procedures.

Details about what to expect from recovery are as follows.

How long does recovery take?

Recovery times will differ between people. How long it takes a person to recover can depend on various reasons, such as:

  • overall health
  • age
  • the site of their surgery
  • the type of glossectomy

Some people may experience long-term or permanent effects from the surgery, such as altered speech and difficulty chewing.

Can a person talk or taste after the procedure?

A person may experience difficulty talking or making sounds after the procedure. They may have to communicate with others differently, for example, by writing down what they want to say.

Some may require further treatment to help them with speech. For example, if someone has had a laryngectomy procedure alongside the glossectomy, they may require an electrolarynx device or extensive speech and voice therapy.

A glossectomy may not affect taste for some people, as airflow to the nasal cavity is the main facilitator of taste.

Although some people believe different tongue areas are responsible for different tastes, this is likely untrue. All areas of the tongue represent all the taste senses. This means a person can lose part of their tongue without losing the ability to experience specific tastes.

Still, a glossectomy that removes a large portion or all of the tongue may affect taste. A 2014 study found that people who underwent a glossectomy that left them with less than 1/3 of their tongue experienced taste abnormalities.

A glossectomy can permanently alter a person’s speech. They may also experience problems, including:

  • weakness and coordination problems in the tongue
  • trismus, a condition in which the jaw does not open fully
  • difficulty with prosthetics
  • damaged vocal folds in the larynx

Speech and voice therapy can help people improve their speaking ability. This therapy employs exercises, devices and tools, massage, and other techniques.

After undergoing a glossectomy, a person should contact a doctor if they experience side effects, such as:

In gossectomy, surgeons remove part or all of the tongue. Surgeons typically perform this to remove a cancerous tumor from the tongue.

The healthcare team in charge of a person’s care will perform a preoperative assessment and advise the person on what to expect during the procedure. Generally, a person will receive general anesthetic before the procedure and may have to spend a few days in the hospital. Recovery times can vary depending on multiple factors.

After the procedure, people may experience changes in their ability to speak and swallow. A person may need rehabilitation with speech therapy or devices to relearn these functions.