Introduction:

Glossectomy is a surgical procedure that involves the partial or total removal of the tongue. This comprehensive article aims to provide an overview of glossectomy, including its indications, types, surgical techniques, recovery, and potential complications.

Indications for Glossectomy:

Glossectomy may be performed in the following situations:

• Oral cancer: Glossectomy is often indicated for the treatment of tongue cancer when other treatment modalities, such as radiation therapy or chemotherapy, have not been effective or when the tumor is large or invasive.
• Trauma: In cases of severe tongue trauma, such as extensive lacerations or avulsion injuries, glossectomy may be necessary to manage the injury and ensure proper healing.
• Congenital abnormalities: Rarely, glossectomy may be performed in individuals with severe congenital abnormalities affecting the tongue, such as macroglossia (enlarged tongue) or certain syndromes.

Types of Glossectomy:

Glossectomy can be classified into different types based on the extent of tongue removal:

• Partial glossectomy: In this procedure, only a portion of the tongue is removed, typically the tumor or the affected area. The remaining healthy tissue is preserved to maintain speech and swallowing functions.
• Hemiglossectomy: This refers to the removal of one-half (hemilateral) of the tongue, usually performed for larger tumors confined to one side of the tongue.
• Total glossectomy: In this procedure, the entire tongue is removed. Total glossectomy is performed when the tumor involves the entire tongue or when the tumor is recurrent and extensive.

Surgical Techniques for Glossectomy:

Glossectomy can be performed using different surgical techniques, including:

• Transoral approach: In this approach, the surgeon accesses the tongue through the mouth. The tumor or affected portion of the tongue is carefully excised, and the wound is closed using sutures. This technique allows for direct visualization and access to the tongue without external incisions.
• Transmandibular approach: In certain cases, glossectomy may require a combined approach where an incision is made in the lower jaw (mandible) to access and remove the tumor or affected tongue tissue. This approach provides better exposure for larger tumors or when there is involvement of the base of the tongue.

Recovery and Rehabilitation:

After glossectomy, the individual will require a period of recovery and rehabilitation. This may involve:

• Speech therapy: A speech-language pathologist will work with the individual to develop strategies for speech and swallowing rehabilitation. Techniques may include learning to articulate sounds using the remaining structures in the mouth and practicing swallowing exercises.
• Nutritional support: Depending on the extent of tongue removal and functional changes, nutritional support may be necessary. This can involve modifications to the diet, such as soft or pureed foods, and the use of feeding tubes in some cases.
• Dental and oral care: Maintaining good oral hygiene and regular dental check-ups are important to prevent complications such as oral infections and tooth decay.

Potential Complications of Glossectomy:

Like any surgical procedure, glossectomy carries certain risks and potential complications, including:

• Difficulty with speech and swallowing: Glossectomy can significantly impact speech and swallowing function. Rehabilitation and working closely with a multidisciplinary team can help manage these challenges.
• Changes in taste and sensation: Tongue removal can affect the sense of taste and sensation in the mouth. However, these changes can vary among individuals.
• Emotional and psychological impact: Adjusting to the physical and functional changes after glossectomy can be emotionally challenging. Emotional support from healthcare professionals, support groups, and loved ones can be beneficial.

Conclusion:

Glossectomy is a surgical procedure performed to partially or completely remove the tongue. It is primarily indicated for tongue cancer or severe tongue trauma. The specific type of glossectomy and surgical technique used depend on the extent and location of the condition. Recovery and rehabilitation involve speech therapy, nutritional support, and oral care. While glossectomy has significant functional and emotional implications, with appropriate support and rehabilitation, individuals can adapt to their new circumstances and achieve a good quality of life.

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