What you need to know about glossectomy

'Glossectomy'… That means that even when you hear about a surgery to remove the tongue, your body feels a little numb, doesn't it? In fact, when you have to talk about such a major surgery, when you have to face it, it is very normal for fear, anxiety, and many big questions to come to your mind. "Will I never be able to talk again?", "Will I never be able to eat?", "What will my life be like in the future?" These things may echo in your mind. But if we know the exact and clear information about this, the fear and uncertainty in your mind can be reduced to a great extent. So let's talk about this glossectomy surgery today, as if you were talking to your own friend or family member.

Simply put, what is a 'Glossectomy'?

Glossectomy is a surgical procedure to remove your tongue. However, the entire tongue is not always removed. It depends on the nature and extent of the condition. It can be divided into several main types.

So, why do you need to have this kind of surgery?

In most cases, a glossectomy is performed as a treatment for tongue cancer. This may be necessary to remove cancer cells and stop them from spreading to other parts of the body.

But the cause is not always cancer. There are times when this surgery has to be done for several other reasons.

• Obstructive Sleep Apnea: Some people may have a condition where their tongue falls back during sleep, blocking their airway. If this is severe and other treatments have not worked, surgery may be recommended to remove part of the tongue and keep the airway open.
• Macroglossia (enlarged tongue): If the tongue is abnormally large, either due to birth or another medical condition, it can make it difficult to speak, eat, or even breathe. In such cases, this surgery is performed to reduce the size of the tongue.

What happens before the surgery?

When you decide to have this kind of surgery, the doctors don't just rush you into surgery. There are a lot of tests and preparations that need to be done before that.

1. Medical examination: First, the doctor will examine you completely. He will carefully examine your mouth, tongue, and neck area.

2. Imaging Tests: Next, you will be asked to do a test like a CT scan or MRI scan to see exactly how far the problem in your tongue has spread and how deep it is.

3. Biopsy: This is a very important step. In this, a very small piece of tissue is taken from the suspicious area of ​​the tongue and sent to a laboratory for testing. This is what will confirm exactly whether it is cancer or not, and if so, what type.

After all of this, the doctor will give you a series of instructions about what you need to do before the surgery. For example, stopping eating and drinking the night before the surgery, and giving you advice about other medications you should take. It is very important to follow these instructions exactly.

What happens during the surgery?

When you go into the operating room, you will first be given general anesthesia so that you will not feel any pain or discomfort. This means that you will be completely asleep until the surgery is over.

Then, the surgeon will perform the appropriate surgery based on your condition.

• In a partial glossectomy: The doctor carefully removes only the diseased part of the tongue and closes the rest with stitches. Sometimes, a small piece of tissue (tissue graft) taken from another part of the body may be used to fill the gap left by the removal.
• In a hemiglossectomy: When half of the tongue is removed, there is a higher chance of difficulty breathing due to swelling of the tongue after the surgery. Therefore, sometimes a tracheostomy is also performed at the same time as this surgery. Don't worry, this involves making a small temporary hole in the front of the neck to make breathing easier. Your doctor will discuss this with you before the surgery.
• In a Total Glossectomy: When the entire tongue is removed, a new tongue-like structure is created to fill the gap. For this, surgeons take skin and tissue from another part of your body, such as your arm, chest, or thigh . The new tissue is connected to blood vessels in your neck to provide blood flow. These are very complex and advanced surgeries.

What happens after the surgery?

After the surgery, you will need to stay in the hospital for a few days, often up to a week. During this time, the doctors and nursing staff will regularly check on your condition.

Sometimes, especially if surgery was performed for a cancerous condition, your doctor may also recommend radiation therapy to destroy any remaining cancer cells and reduce the risk of the cancer coming back.

What are the benefits and risks of this surgery?

Like any medical treatment, this surgery has its benefits and risks.

The main advantage

The biggest and most important advantage of this surgery is that it is a very successful treatment for tongue cancer. This surgery is the primary treatment for cancer, especially in the mobile part of the tongue. It has a very high chance of saving a life.

Possible risks

As with any surgery, there are risks and complications that can occur, and it's important to be aware of these beforehand.

How long does it take to recover? Life after surgery...

This is the biggest question many people have: "How long will it take for me to get back to living a normal life?"

Actually, the healing time depends entirely on how much of your tongue was removed.

• Partial Glossectomy (if part of the tongue is removed): You will be able to eat and drink normally in about two weeks.
• Total Glossectomy (if the entire glossectomy is removed): The ability to swallow may be completely lost. In such cases, liquid nutrition may need to be given through a nasogastric tube (NG tube) or a tube connected to the stomach (PEG tube).

In any case, it is essential to continue working with your speech and language therapist.

What happens to the ability to speak?

This also depends on the amount of tongue removed.

• People who have had part of their tongue removed: They may still be able to pronounce many sounds and words. This ability can be further improved with speech therapy.
• People who have had their entire tongue removed: They may lose the ability to speak, but that doesn't mean they lose touch with the world. They can communicate with others using technology, such as a pen and paper, a tablet, or a computer .

What happens to the sense of taste?

This problem is understandable, since our sense of taste is found on the tongue. Research has shown that people who have at least half of their tongue base intact have a good sense of taste. However, if more than half of the tongue is removed, it can cause some difficulty distinguishing and identifying certain tastes (dysgeusia) .

But surprisingly, even some patients who have had their entire tongue removed (total glossectomy) have been reported to have some degree of taste and ability to enjoy food.

If you have these symptoms, see a doctor immediately!

Once you return home after surgery, it is important to pay close attention to the changes in your body. If you experience any of the following symptoms, call your doctor immediately or go to the Emergency Department (ETU) of your nearest hospital.

Glossectomy is truly a life-changing surgery. Making such a decision is a very personal and difficult one. So, talk to your doctor carefully and make sure you understand all of your treatment options. Ask any questions you may have about the pros and cons of this surgery and what to expect after the procedure. The recovery process can be challenging, but remember, you have a team of doctors, nurses, and especially speech therapists to help you. With their help, you can learn to speak, swallow, and improve your quality of life.

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