GLOSSECTOMY SURGICAL REMOVAL OF TONGUE
Category: Plastic Surgery
Abstract : A glossectomy is the surgical removal of all or part of the tongue.
Purpose 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
A glossectomy is the surgical removal of all or part of the tongue.
Purpose
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.
Demographics
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.
Description
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.
Diagnosis/Preparation
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 patients 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.
Aftercare
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.
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