During a glossectomy, doctors remove all or part of a person’s tongue. A glossectomy can sometimes cure cancer of the tongue. However, the procedure is not always successful and can cause serious long-term effects.
Tongue cancer is a form of oral cancer.
This article discusses what there is to know about a glossectomy for tongue cancer, including the procedure, types, and risks.
“Glossectomy” is the term for any surgical procedure that aims to remove all or part of the tongue.
Oral cancer that begins on the tongue could spread to other parts of the mouth.
By removing the parts of the tongue that contain cancer cells or precancerous lesions, doctors hope to cure the oral cancer or at least slow its development.
Healthcare professionals define these in terms of how much of the tongue the procedure aims to remove. The main types of glossectomy are as follows:
- Partial glossectomies: Surgeons remove less than half the tongue.
- Hemiglossectomies: Surgeons remove half the tongue.
- Subtotal glossectomies: Surgeons remove more than half the tongue but not all of it.
- Total glossectomy: Surgeons remove the whole tongue.
- Composite resection: Surgeons remove bone in addition to all or part of the tongue.
Doctors will recommend whichever glossectomy has the greatest chance of treating the cancer.
They will also try to preserve as much tongue as possible, as losing parts of the tongue can make speaking and eating difficult.
Glossectomies require preparation and recovery.
Every operation is different. A person’s surgeon should explain what their glossectomy may involve.
The United Kingdom’s National Health Service (NHS) discusses what an individual may expect at each stage of the process.
In preparation for a glossectomy, individuals should do their best to maintain good health.
Although this will vary from person to person, the following guidelines will apply to many:
- eating plenty of fruit, vegetables, and protein
- eating healthy and high energy foods, if underweight or losing weight
- limiting or stopping alcohol consumption
- limiting or stopping tobacco smoking
An individual may need to avoid eating solid foods for a certain amount of time before the operation. The time frame varies by facility, and a doctor will advise on the exact procedure a person should follow.
Surgeons may also recommend that a person avoid drinking fluids for some time before surgery. They may recommend drinking a special carbohydrate-rich liquid beforehand.
Just before surgery, an anesthesiologist will place the individual under general anesthesia.
During less extensive glossectomies, surgeons will remove a smaller section of the tongue and stitch the opening.
However, during more extensive glossectomies, surgeons must perform reconstructive surgery after removing some of the tongue.
Reconstructive surgery involves removing a portion of skin or muscle from another part of the body and grafting it onto the tongue. Surgeons may remove this skin or muscle from the neck, arm, or leg. Reconstructive surgery can restore some tongue functionality.
A glossectomy without reconstructive surgery should take 1–2 hours, while glossectomies in which surgeons must perform reconstructive surgery can last 8–10 hours.
Surgeons may also need to perform additional procedures, such as a neck dissection or a tracheostomy.
When someone wakes up after a glossectomy, medical staff will take them to a recovery unit.
After some time, staff may move the person to a different ward.
Nursing staff and doctors will care for the individual throughout their hospital stay. This might involve:
- providing pain relief
- applying and using temporary feeding devices such as intravenous drips or feeding tubes
- monitoring for any complications from surgery and responding to them
If the individual did not receive reconstructive surgery, doctors may discharge them within 2 days. If they did receive this surgery, they might stay in the hospital for up to 2 weeks.
A glossectomy may be an outpatient surgery, depending on the type and procedure.
In any case, the individual will need to undergo therapy to help them with speaking and eating. In some cases, people may need this therapy for a few years.
There is evidence that glossectomies can help cure oral cancer, at least temporarily.
For instance, a small 2020 study with 85 participants found that
A major glossectomy involves removing some bone in addition to the tongue. The survival rates and outlook are better for those with less advanced cancer who undergo a partial glossectomy.
Despite these benefits, a
Because glossectomies involve removing some of the tongue, they can create problems with breathing, eating, and tasting.
Moreover, a glossectomy can pose risks
With some glossectomies, there is also a risk that reconstructive surgery may fail.
This can happen if the tongue does not supply enough blood to the graft. These reconstructive surgery failures require further surgery.
This section answers some frequently asked questions about glossectomies for oral cancer.
How long does it take for your tongue to heal after a partial glossectomy?
Recovery time for a partial glossectomy may vary depending on the person and facility.
Some facilities may discharge a person and recommend that they follow a liquid diet for a specific period.
In other cases, a person might stay in the hospital on a liquid diet or with feeding tubes until doctors can remove their dressings.
According to the NHS, full recovery can take several weeks.
Why do people get a glossectomy?
Glossectomies allow doctors to remove cancer or precancerous lesions from a person’s tongue.
Do they remove your tongue if you have tongue cancer?
Doctors do not always recommend glossectomies for tongue cancer. Even when they do, surgeons do not always remove the whole tongue.
If doctors discover cancer on a person’s tongue, they may recommend a glossectomy.
During this procedure, surgeons remove all or part of a person’s tongue. In doing so, they aim to cure a person’s cancer by removing as many cancer cells as possible.
For more extensive glossectomies, surgeons will also need to perform reconstructive surgery.
Although glossectomies are sometimes successful, they can have significant long-term negative effects. An individual should carefully discuss the possibility of glossectomy with their doctor.