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Glossectomy

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on April 14, 2022.

When dealing with tongue cancer, you may undergo a primary surgical treatment called a glossectomy, which is the removal of all or part of the tongue. A glossectomy is typically performed for the treatment of malignant and pre-malignant tongue lesions. How extensive and complicated the surgery is depends on the location of the tumors on the tongue and the extent of the lesions.

Tongue cancer surgery may have significant quality-of-life implications. The procedure may affect a patient’s ability to speak, eat and swallow.

In addition to treating tongue cancer, a glossectomy may be used to treat some cases of obstructive sleep apnea or an abnormal enlargement of the tongue (macroglossia).

In this guide, we’ll examine the three basic types of glossectomy:

If you have been diagnosed with tongue cancer or any other type of head and neck cancer and are interested in a second opinion on your diagnosis and treatment plan, call us or chat online with a member of our team.

Partial glossectomy

A partial glossectomy removes a portion of the tongue. This is a common procedure for tongue cancer, especially for early-stage disease. After removing the cancerous portion of the tongue, the surgeon removes some surrounding tissue, in order to capture cancer cells that may have been missed.

Typically, the malignancy is located in the front third of the tongue, which often allows the surgery to be performed through the mouth. Sometimes, a tumor may be in a harder-to-reach area, requiring the surgeon to make an incision in the neck or jaw in order to excise the cancer.

Reconstructive surgery may be needed as part of the procedure, depending on the complexity of the procedure and the amount of tongue removed. When more than half the tongue is removed, the surgery is referred to as a subtotal glossectomy.

Eating after a partial glossectomy may not be possible in the first few days following surgery. Your doctor may insert a feeding tube, either directly to the patient’s stomach (gastric tube) or through the nose to the stomach (nasogastric tube), until swelling in the throat subsides.

Hemiglossectomy

The tongue is a muscular organ divided into mirrored halves. A hemiglossectomy removes one side of the tongue, a lateral half. During surgery, doctors may also perform a tracheostomy, making an opening in the skin that allows for a tube to be inserted into the windpipe (trachea) to assist with the patient’s post-operative breathing.

Reconstructive surgery is usually performed as part of the procedure to restore normal speech and appearance. This may include a skin graft, typically using tissue taken from the thigh or upper arm, to replace tissue that’s been removed.

Total glossectomy

A total glossectomy is the complete removal of the tongue. Reconstructive surgery is needed to allow for swallowing and speaking. Without reconstructive surgery, the patient won’t be able to swallow without getting food or liquid into their lungs (aspiration). In some cases, a laryngectomy, which removes the patient’s voice box (larynx), may also be required to prevent aspiration. A laryngectomy would prevent the patient from speaking normally.

Side effects of a glossectomy

The side effects that may be result from a glossectomy include:

  • Difficulty speaking, reduced speech intelligibility, loss of speech
  • Difficulty swallowing
  • Altered tongue sensations
  • Salivary fistulas, which are holes that allow saliva to leak into the neck through the floor of the mouth
  • Infections, non-healing wounds
  • Aspiration, where food, fluid or saliva enters the lungs instead of the stomach
  • Pain
  • Bleeding
  • Pneumonia
  • Weight loss
  • Damage to nearby oral structures
  • Healing issues, such as a reconstruction failure
  • Anesthesia risks, including cardiopulmonary events, strokes or death

The glossectomy recovery process

Recovering from a glossectomy may take time, even after the patient has returned home. In general, healing for a partial glossectomy may take several weeks before the pain subsides.

Special attention needs to be given to oral hygiene, to reduce the possibility of infection following surgery. The patient may also be placed on a soft-food diet to prevent damage to the structure of the mouth during recovery, and extensive speech therapy may be recommended to help them recover some of their ability to speak.

Two major causes of tongue cancer are tobacco and alcohol use. These behaviors should be stopped once the patient is diagnosed, especially since patients who continue smoking and drinking during and after treatment increase their likelihood of a cancer recurrence.

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