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​What is Glossectomy?

Glossectomy refers to the surgical removal of a part or all of the tongue affected by cancer.

Types of Glossectomy

  1. Partial Glossectomy
    Removal of less than half of the tongue
  2. Hemi Glossectomy
    Removal of half of the tongue
  3. Subtotal Glossectomy
    Removal of up to 70-80% of the tongue
  4. Total Glossectomy
    • Removal of the entire tongue
    • The voice box may be removed (called a laryngectomy) at the same if the cancer has spread to the voice box.

How is the Surgery Performed?

  • Performed under general anaesthesia.
  • A tracheostomy and/or feeding tube may be required depending on the extent of surgery and flap reconstruction.
  • Removal of more than half of the tongue generally requires a flap reconstruction to restore the form and function of the tongue.
  • For large tumours, the surgeon may need to split the jaw bone (called a mandibulotomy) for better access during surgery.
  • If the jaw bone is affected, the affected area would need to be removed at the same time (called a mandibulectomy).

Preparation for Surgery

  • You are required to undergo anaesthesia review and blood tests before the surgery to determine your fitness for surgery.
  • Your dietician will conduct a nutritional assessment to develop an ideal plan for your food intake.
  • You may need to stop aspirin and other blood thinning medications seven to ten days before surgery to reduce the risk of bleeding. If you have to continue them for other medical reasons, please check with your surgeon.
  • Your surgery may be postponed if you develop a fever, cold, flu, sore throat or any other illnesses 24 to 48 hours before day of surgery. Please inform the ENT clinic or surgeon if you feel unwell before surgery.
  • Stop smoking at least one week before surgery. This will help you recover faster from the surgery in terms of breathing and wound healing.

What to Expect Immediately After the Surgery?

  • Stitches or staples around the surgical site
  • Numbness around the surgical site
  • Drains placed during the surgery
  • Wound dressing over the area where flap was harvested
  • Feeding tube and/or tracheostomy tube may be inserted during the surgery

Possible Risks of Surgery

  1. Bleeding
    There is a risk of bleeding from the wound site which can lead to swelling and blockage of the airway. Drains will be placed during surgery to facilitate drainage of excess fluid and prevent formation of blood clots.
  2. Fistula Formation
    A communication passage between the oral cavity and skin and/or neck may develop following surgery. It is more common in patients with previous radiotherapy and with poor nutrition, which makes healing slower.
  3. Change in Speech and Swallowing
    Your speech, chewing and swallowing may be affected by the surgery. A speech therapist will work with you to improve these functions.
  4. Flap Failure
    Reconstruction of the tongue with a flap is a complex procedure, as it involves re-establishing blood flow to the newly constructed tongue. Another surgery may be needed if the flap breaks down.
  5. Altered Taste
    Following surgery, your sense of taste will be affected.


Home Care After Surgery

  • Activity
    Avoid strenuous activities until further instructions from your surgeon. Continue doing the exercises taught by your physiotherapist or speech therapist.
  • Diet
    There are no restrictions on your diet (unless prescribed). If you are on feeding tube, take the nutritional fluid diet as advised by your dietician.
  • Medications
    Take your pain mediations and antibiotics as prescribed.
  • Wound Care
    Keep the wounds clean and dry and Maintain good oral hygiene.

    Check your wound daily for:
    • Redness
    • Swelling
    • Discharge (blood, pus)
    • Severe pain

If you develop any of the above, please inform the ENT clinic or surgeon immediately.

  • Follow-up Appointments
    Please keep to your appointment dates for review with the surgeon, speech therapist, dietician and the rest of the oncology team.
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