What is Glossectomy: Overview, Benefits, and Expected Results
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What Is Glossectomy: Overview, Benefits, and Expected Results
Glossectomy is the surgical removal of part or all of the tongue. This procedure is typically conducted for medical-related reasons when medical treatment proves ineffective. The tongue is considered to be the most versatile and active organ of the body. It is also the heaviest and largest organ of the mouth, and it makes up a large portion of the overall digestive system.
In a glossectomy, the equivalent of a portion or the entirety of the tongue is surgically removed. This procedure is usually performed to remove tumors, cancers, or lesions from the mouth. Besides, this surgery can also be done to treat severe trauma or birth defects. A glossectomy can help improve a patient’s overall quality of life by eliminating any related symptoms and aligning with any goals related to diet, speech, and lifestyle.
Overview of Glossectomy Procedure
Glossectomy is referred to as a surgical intervention for many conditions. The procedure can be either a partial glossectomy, which is the removal of part of the tongue, or a total glossectomy, which is the removal of the entire tongue. In either case, tissue loss is required.
The tissue that is removed can include parts of the tongue, the base of the tongue, and the tonsils. Additionally, the surrounding neck muscles can also be reshaped to make up for the portion of the tongue that has been removed and create stability for the tongue muscles that are left.
The glossectomy procedure also includes reconstruction of the affected area by utilizing techniques such as stitching, tissue grafts, and implants. Once the area has been reconstructed, other treatments, such as radiation therapy, may be necessary to prevent the growth of any additional tumors or cancerous cells.
Benefits of Glossectomy
The primary benefit of glossectomy is that the procedure can provide relief from the symptoms associated with oral tumors, cancers, or lesions. By removing the affected area, the patient is able to experience improved quality of life by avoiding pain and eating more comfortably. Glossectomy can also provide relief from any difficulty the patient may be experiencing with speaking as a result of the area being affected. It can even improve a patient’s speech, as the affected area can be reconstructed to function as a regular tongue does.
Another benefit of a glossectomy is that the procedure can greatly reduce the risk of the cancer spreading to other parts of the body. By removing the affected area, any cancer cells that may be present in the surrounding tissue can be more easily detected and treated.
Expected Results from Glossectomy
The results of a glossectomy depend largely on the nature and extent of the surgery. For those who opt for a partial glossectomy, the removed parts of the tongue can typically be reconstructed with oral tissue grafting to preserve much of the patient’s natural tongue. In this case, the patient should notice a reduction in any symptoms associated with the condition, and their speech should remain relatively unchanged.
For those who have a total glossectomy, the full tongue must be replaced with an artificial one to enable speech and improve quality of life. This is a much more complicated process, although the patient should still notice a decrease in symptoms and be able to speak normally again after a period of physiotherapy and speech therapy.
Post-Glossectomy Rehabilitation
It is important that a patient goes through a post-glossectomy rehabilitation process to regain speech functions and maximize the post-glossectomy potential. The process includes comprehensive instructions on how to use the reconstructed area and the artificial tongue. It is also necessary to use a speech aid to help the patient pronounce words properly.
At first, the patient may be unable to pronounce words correctly, but gradually, their proficiency should improve while undergoing intensive speech therapy and healing. In the long-term, the patient should be able to speak with just a slight accent noticeable.
In addition to speech therapy, the patient can also undergo physical therapy, to help improve muscle strength and coordination. Physical therapy, in combination with speech therapy, can help restore movement in the tongue and the surrounding structures, thus allowing the patient to eat and swallow naturally, and ultimately improving their quality of life.
Summary
Glossectomy is a surgical procedure that involves the removal of part or all of the tongue. It can be used to remove tumors, cancers, or lesions from the mouth and to treat severe trauma or birth defects. The results of a glossectomy depend largely on the nature and extent of the surgery, but in either case, a post-glossectomy rehabilitation process is necessary to regain speech functions and maximize the patient’s potential. The patient should experience an improvement in quality of life by gaining relief from associated symptoms and regaining the ability to speak normally.
Definition and Overview
Glossectomy is the partial or complete removal of the tongue. It is performed to treat tongue cancer and other forms of oral cancer that affect or have already spread to the tongue, particularly its base. It is performed by an oncological surgeon specialising in head, neck, and throat cancers.
Glossectomy is considered as one of the most challenging surgical procedures not just because the tongue is a highly muscular organ but also because it performs a variety of crucial functions that are necessary for digestion and speech. Therefore, the surgeon has to take all the precautions to ensure that the tongue’s functions are retained as much as possible. This can be achieved by ensuring that the removal is limited to the diseased area while reducing the likelihood of the spread of the disease. In cases wherein two-thirds of the tongue is resected, the surgeon needs to follow the procedure up with reconstructive surgery.
Who Should Undergo and Expected Results
There are two major reasons for glossectomy: tongue cancer and other types of oral cancer.
Tongue cancer is a type of oral cancer that affects either the base (the part of the tongue that is closer to the throat) or the oral (the part of the tongue that is visible when speaking or eating). Although there are many different kinds of tongue cancer, the most common is squamous cell carcinoma, which may also vary depending on where it originates. Some common signs and symptoms of tongue cancer are pain when swallowing, change in voice quality (e.g., becoming hoarse), the presence of red or white patches on the tongue that persist for weeks), bleeding of the tongue, and ulcerations.
Since the tongue is part of the oral cavity, it can also be affected by other forms of oral cancer such as throat, mouth, and lips cancers.
Glossectomy can be the primary and only treatment if tongue cancer is limited to a very small area or the disease has been detected in the early stages. However, if it has already spread to other parts of the oral cavity as well as the neck, the surgery is often combined with other treatments like chemotherapy and radiotherapy.
The results of the surgery can differ depending on the exact procedure performed. In partial glossectomy, it is possible for the patient to retain or restore speech, as well as the ability to swallow and position food. However, if it’s complete glossectomy, these activities may be severely limited even after tongue prosthesis has been attached.
How Does the Procedure Work?
Tongue resection is usually an inpatient procedure performed in a hospital under general anaesthesia.
Surgeons can choose different approaches based on the location of the lesions or cancer. For example, if the cancer is found in the oral tongue, the lesion can be accessed directly through the mouth. However, if it is located in the base, the surgeon may opt for robot-assisted surgery, laser microsurgery, or mandibulotomy. In robot-assisted surgery, the mouth is kept wide open while robotic arms, which are controlled by the surgeon, are used to remove cancer in a more precise manner. In laser microsurgery, the surgeon uses a laryngoscope, a probe that is inserted into the larynx to get real-time visuals of the throat including the base of the tongue, and uses laser technology to remove the lesions. Mandibulotomy is more complex since it involves creating an incision in the jaw and putting it on the side so the surgeon can see and operate on the tongue.
The removed tongue samples will be sent for biopsy to check for any presence of cancer, and depending on the result, the resection may continue until the samples come back clear. After the tongue removal, the surgeon may proceed to reconstruct the tongue using different flap techniques or by attaching tongue prosthesis.
The surgery may take at least an hour to complete, after which the patient is wheeled into the recovery room. In the majority of cases, the patient is connected to a feeding tube for about a week.
Possible Risks and Complications
Tongue resection has many possible risks and complications, which explains why the patient has to stay in the hospital for a few days. These include common surgical risks such as bleeding and infection. In some cases, the patient may also experience difficulty in swallowing or speaking, leaking of saliva from the mouth to the neck (saliva fistula), and pneumonia.
Reference
- Eusterman VD. History and Physical Examination, Screening and Diagnostic Testing. Otolaryngol Clin North Am. Feb 2011;44(1):1-29. PMID: 21093621 www.ncbi.nlm.nih.gov/pubmed/21093621.
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Interesting! Thanks for the info. #Medical #Surgery
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Great to know! #HealthyLifestyle #PossibleCure #Surgeries
Very informative! #KnowledgeIsPower #Glossectomy