Can you talk after a Glossectomy?

Glossectomy is a surgical procedure done to remove all or part of the tongue.
Glossectomy is a surgical procedure done to remove all or part of the tongue.

Glossectomy is a surgical procedure done to remove all or part of the tongue.

Most often, glossectomy is followed by a procedure known as a tracheostomy. Glossectomy may initially cause a lot of swelling in the throat and block the respiratory passage. This can make breathing difficult. A small tube is put into a hole (incision) created into the neck to make breathing easier. This procedure is known as a tracheostomy. The tracheostomy tube is usually kept for a few days until the swelling subsides and finally disappears.

Why is glossectomy done?

Glossectomy is commonly performed for the treatment of malignant and precancerous (or "potentially malignant") tumors of the mouth. It is also done for correcting problems, such as severe obstructive sleep apnea (temporary, frequent cessation of breathing during sleep), and macroglossia (huge tongue).

What are the types of glossectomy?

Glossectomy is a term used to describe a family of surgical procedures that results in the removal of the tongue.

There are various ways in which glossectomy is classified. The most common classification is based on which side of the tongue is removed:

  • Left glossectomy
  • Right glossectomy
  • Midline glossectomy

Based on the proportion of tongue removed, glossectomy is of four types. These include:

  • Partial glossectomy (less than one-half)
  • Hemi-glossectomy (half of the tongue)
  • Subtotal glossectomy (more than 50% of the tongue, but less than a total glossectomy)
  • Total glossectomy (whole tongue removal)

How does glossectomy affect speech?

Speech outcome after glossectomy depends on the site of the tumor, the extent of removal of the tongue, and flexibility of the remaining structures.

Rehabilitation of speech with the help of a speech therapist plays a vital role in preventing severe speech problems and re-establishing interpersonal communication. Rehabilitation makes use of oral facilitative exercises, direct articulation techniques, compensatory techniques, surgical procedures, and prosthetic appliances.

Oral facilitative exercises: This type of exercise helps improve the strength and range of movement of the articulators (lips, tongue).

Direct articulation techniques: Also known as speech-sound therapy; it involves working on the placement of articulators inside of their mouth to correctly produce their sounds.

Prosthetic procedures are preferred usually than surgical procedures.

How do you eat after glossectomy?

If only a small proportion of your tongue has been removed, you may be able to eat through your mouth.

If a major proportion or whole of your tongue has been removed, you may not be able to eat through your mouth. The doctor will insert a long tube known as a gastrostomy tube into your mouth that goes into your stomach. The nurse will administer feeds through this tube.

Good nutrition is vital to the healing of the surgical area and for preventing major weight loss after the surgery. The gastrostomy tube is attached to a bag filled with fluid that contains all the important nutritional elements.

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What are the complications of glossectomy?

Every surgery carries a few risks and glossectomy is no exception to this. The complications of glossectomy include:

  • Pain
  • Bleeding
  • Infection
  • Scarring
  • Damage to nearby structures/organs
  • Risks of general anesthesia (such as breathing difficulty, paralysis)
  • Difficulties with speech or swallowing
  • Altered taste
References
Myers LL. Glossectomy. Medscape. https://emedicine.medscape.com/article/1890823-overview

Saravanan G, Ranganathan V, Gandhi A, et al. Speech Outcome in Oral Cancer Patients - Pre- and Post-operative Evaluation: A Cross-sectional Study. Indian J Palliat Care. 2016;22(4):499-503. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5072244/

Bigcas JLM, Okuyemi OT. Glossectomy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; January 2020. https://www.ncbi.nlm.nih.gov/books/NBK560636/