A glossectomy is the surgical removal of all or part of the tongue.
A glossectomy is performed to treat cancer of the tongue. Removing the tongue is indicated if the patient has a cancer that does not respond to other forms of treatment. In most cases, however, only part of the tongue is removed (partial glossectomy). Cancer of the tongue is considered very dangerous due to the fact that it can easily spread to nearby lymph glands. Most cancer specialists recommend surgical removal of the cancerous tissue.
According to the Oral Cancer Foundation, 30,000 Americans will be diagnosed with oral or pharyngeal cancer in 2003, or about 1.1 persons per 100,000. Of these 30,000 newly diagnosed individuals, only half will be alive in five years. This percentage has shown little improvement for decades. The problem is much greater in the rest of the world, with over 350,000 to 400,000 new cases of oral cancer appearing each year.
The most important risk factors for cancer of the tongue are alcohol consumption and smoking. The risk is significantly higher in patients who use both alcohol and tobacco than in those who consume only one.
Glossectomies are always performed under general anesthesia. A partial glossectomy is a relatively simple operation. If the "hole" left by the excision of the cancer is small, it is commonly repaired by sewing up the tongue immediately or by using a small graft of skin. If the glossectomy is more extensive, care is taken to repair the tongue so as to maintain its mobility. A common approach is to use a piece of skin taken from the wrist together with the blood vessels that supply it. This type of graft is called a radial forearm free flap . The flap is inserted into the hole in the tongue. This procedure requires a highly skilled surgeon who is able to connect very small arteries. Complete removal of the tongue, called a total glossectomy, is rarely performed.
If an area of abnormal tissue has been found in the mouth, either by the patient or by a dentist or doctor, a biopsy is the only way to confirm a diagnosis of cancer. A pathologist, who is a physician who specializes in the study of disease, examines the tissue sample under a microscope to check for cancer cells.
If the biopsy indicates that cancer is present, a comprehensive physical examination of the patient's head and neck is performed prior to surgery. The patient will meet with the treatment team before admission to the hospital so that they can answer questions and explain the treatment plan.
Patients usually remain in the hospital for seven to 10 days after a glossectomy. They often require oxygen in the first 24–48 hours after the operation. Oxygen is administered through a face mask or through two small tubes placed in the nostrils. The patient is given fluids through a tube that goes from the nose to the stomach until he or she can tolerate taking food by mouth. Radiation treatment is often scheduled after the surgery to destroy any remaining cancer cells. As patients regain the ability to eat and swallow, they also begin speech therapy.
Risks associated with a glossectomy include:
A successful glossectomy results in complete removal of the cancer, improved ability to swallow food, and restored speech. The quality of the patient's speech is usually very good if at least one-third of the tongue remains and an experienced surgeon has performed the repair.
Total glossectomy results in severe disability because the "new tongue" (a prosthesis) is incapable of movement. This lack of mobility creates enormous difficulty in eating and talking.
Even in the case of a successful glossectomy, the long-term outcome depends on the stage of the cancer and the involvement of lymph glands in the neck. Five-year survival data reveal overall survival rates of less than 60%, although the patients who do survive often endure major functional, cosmetic, and psychological burdens as a result of their difficulties in speaking and eating.
An alternative to glossectomy is the insertion of radioactive wires into the cancerous tissue. This is an effective treatment but requires specialized surgical skills and facilities.
"Disorders of the Oral Region: Neoplasms." Section 9, Chapter 105 in The Merck Manual of Diagnosis and Therapy , edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 1999.
Johnson, J. T., ed. Reconstruction of the Oral Cavity . Alexandria, VA: American Academy of Otolaryngology, 1994.
Shah, J. P., J. G. Batsakis, and J. Shah. Oral Cancer . Oxford, UK: Isis Medical Media, 2003.
Barry, B., B. Baujat, S. Albert, et al. "Total Glossectomy Without Laryngectomy as First-Line or Salvage Therapy." Laryngoscope 113 (February 2003): 373-376.
Chuanjun, C., Z. Zhiyuan, G. Shaopu, et al. "Speech After Partial Glossectomy: A Comparison Between Reconstruction and Nonreconstruction Patients." Journal of Oral and Maxillofacial Surgery 60 (April 2002): 404-407.
Furia, C. L., L. P. Kowalski, M. R. Latorre, et al. "Speech Intelligibility After Glossectomy and Speech Rehabilitation." Archives of Otolaryngology - Head & Neck Surgery 127 (July 2001): 877-883.
Kimata, Y., K. Uchiyama, S. Ebihara, et al. "Postoperative Complications and Functional Results After Total Glossectomy with Microvascular Reconstruction." Plastic Reconstructive Surgery 106 (October 2000): 1028-1035.
American Academy of Otolaryngology - Head and Neck Surgery. One Prince Street, Alexandria, VA 22314. (703) 806-4444. http://www.entnet.org .
American Cancer Society. National Headquarters, 1599 Clifton Road NE, Atlanta, GA 30329. (800) ACS -2345. http://www.cancer.org
Oral Cancer Foundation. 3419 Via Lido, #205, Newport Beach, CA 92663. (949) 646-8000. http://www.oralcancer.org
CancerAnswers.com. Tongue Base and Tonsil Cancer. http://www.canceranswers.com/Tongue.Base.Tonsil.html .
Cancer Information Network. Oral Cavity Cancer. http://www.ontumor.com/oral/ .
Monique Laberge, Ph.D.
A glossectomy is performed in a hospital by a treatment team specializing in head and neck oncology surgery. The treatment team usually includes an ear, nose & throat (ENT) surgeon, an oral-maxillofacial (OMF) surgeon, a plastic surgeon, a clinical oncologist, a nurse, a speech therapist, and a dietician.
thanking you
My husband is undergoing a glossectomy on Mon.
Just a partial - the doctor said it is a precancerous tumor
What should we expect for recovery and will he be hospitalized overnight or outpatient out in a few hours?/ Just curious what were your thoughts.
Thanks
Mary
Just a partial - the doctor said it is a precancerous tumor..
clinically it is malignancy but pathalogically, the reports are found to be normal......? is it just to avoid cancer?
PLEASE HELP ME.
THANK YOU
how much of the tongue can be removed without affecting the tongue's function?
I can honestly say this is one of the most invasive and life-altering processes I've ever witnessed. After the surgery and 10 days recovery (3 in ICU) I underwent 3 chemo and 30 radiation treatments. I lost about 40 lbs (going from 155 to 115).
Over 2 years later I have limited speech capabilities (difficulties with certain sounds such as hard K) and a severely limited diet/food intake due to the lack of saliva and tongue mobility.
To answer some of the above questions (for future readers):
Rehabilitation starts during recovery, after the trach has been removed. The therapist recommended moving the tongue in each direction as much as possible to exercise the remaining muscles. Speech and swallowing were monitored to determine recovery rate and to assist in therapy. Both therapists recommended various exercises to strengthen the remaining muscle to regain speech and swallowing capabilities. Mostly, it was suggested I drink water when possible, and use certain syllables or sounds that were difficult to improve speech and swallowing.
The surgery takes 10-14 hours to complete and recovery time is at least a week, usually more. Also, radiation and chemo follow almost immediately. Expect to be unable to perform household duties, drive or work more than a few hours a day at a desk job for about 6 months after the initial surgery. I also had a feeding tube implanted in my stomach due to the inability to swallow following the surgery. That was in place for about 7 months following the surgery.
My taste was retained. For several months after I was able to take food by mouth again, I was very sensitive to extreme flavors (salty, sweet and spicy, especially). Bland, soft food is recommended. Jello, puddings (depending on consistency and the individual) and liquid drinks such as Ensure will be your best friend for quite a while, if not for ever (as in my case).
Depending on how much of the tongue is removed and the effects suffered by radiation, normal food consumption may never be possible. I have had some luck with certain solid foods, such as steak cooked rare, hot dogs and a few others. I must consume a lot of water when eating and I become very tired even now. Take things slow and do not try to consume something you are not ready for. This can lead to aspirating or choking due to the weakened muscles.
The tracheotomy is done due to the swelling that may/does occur in the back of the throat. Once the tongue swells due to the surgery, it can restrict access both from the mouth and the nasal passages for air flow. I had mine in for several weeks after the surgery. It is a temporary tube which will require cleaning and suction to maintain air flow. Most patients will require assistance on occasion.
did not recommend surgery and said that the only hope we have is chemo. Radiation can not be used. We were shock, because we knew that chemo alone does not work. We seeked out a second opinion and they said that we could try surgery with a total tongue removal and flap. We need information if its worth it because we can no use radiation. Please help.
Kind Regard,
Phil.
All was well for 7 years when he got a lesion inside his cheek Same side. That had to be
Removed and skin graft from his thigh to inside his cheek. Lymph nodes were also removed
And were negative. He has recovered and it has been 3 years with check ups
Every 6 months. Only thing is he can't get his mouth open wide enough
To get a bite of anything. He eats very soft food from a spoon and has to slurp it. We can't
Figure out why his mouth cannot open further. Drs say it's from radiation? Any clues? Said
Nothing can be done. It is getting harder for him. Getting worried .
I have had 3 rounds of Chemo and 35 Radiation treatments.
I had a PET scan yesterday and am waiting for the results.
I am scared to get the results, and am asking for any help and prayers
you can offer. God bless each one of you.
The cancer just keeps coming back. In October he had a full glossectomy.
He has a feeding tube, will never be able to speak to his 5 and 6 year olds never smell or taste anything ever again. Never be able to kiss his wife. The list just goes on and on,
we make all his food from organic fruits and vegetables and meat. Protein powders, flax oils etc. he is feeling a little more energetic
. How any of you continue on is amazing. My heart goes out to all of you and your caregivers. It is not a great quality but it is life and you get to give them hugs, tell them they are loved.
I wish we had more information. We feel like we are going blind.
They can grow an ear. what research has been done on this horrible cancer?
It is hard to fight to be alive and plan for your death at the same time.
Fight we must. Hope we must. Pray we must. My son was given 3 months, he is in his third month.
It is really hard to watch the suffering, but then you get a few moments of joy together.
Do not forget to laugh. This might be the hardest thing to do.
Now able to eat soft food, but unable to speak properly. AFTER HOW MANY DAYS OF SURGERY, SHE CAN BE ABLE TO SPEAK PROPERLY? thank-you
Brandy
Cannabiss Oil. Although this made sleeping,working and eating easier , it hid the fact that the tumor was growing rapidly. By the time I went back to my doctor I needed the large amount of my tongue removed immediatley . My sugery went well and I was only in hospital 10 days. I can talk some but have a tube in to eat. I can drink fluids and am hopeful that I will eat solids soon. I do have a problem with excessive saliva and am wondering if any one has any ideas about how to help with this. Also I will start Radiation Therapy soon and have decided not to do chemo. I have herd many different opinions about chemo but don't like the odds of improvement in chances to live. My Doctor says that I have a 50/50 chance with out the radiation. An 80/20 chance with and 90/10 chance if I do chemo as well. Any thoughts would be welcome. My best to all my fellow warriors
So, 5 months later, half of my face is numb, so is my chest, part of my neck, and my ears n face. I know I'm gonna be pissed if I pay $3000 for dentures and still cant eat. Oh, btw, I'm 38, n a single divorced Dad.. Dating again NOW scares the hell outta me...
Today I am doing great. Some difficulties with speech and eating but otherwise in good - body and mind. I encourage anyone who is going through this awful experience to take control of your life wherever you can. It is horrendous and scary but you still have some choices in your journey. Xaj