41114 Excision of lesion of tongue with closure; with local tongue flap

Name of the Procedure:

Excision of tongue lesion with closure using a local tongue flap

Summary

In this procedure, a lesion on the tongue is surgically removed, and the resulting wound is closed using a flap of tissue from the tongue itself. This technique is often used to ensure optimal healing and function of the tongue post-surgery.

Purpose

This procedure is performed to remove abnormal growths, such as benign tumors or malignant lesions, from the tongue. The goals are to eliminate the abnormal tissue, prevent potential spread of disease, and promote proper healing of the surgical area.

Indications

• Presence of a suspicious or confirmed lesion on the tongue
• Biopsy results indicating a need for complete removal
• Trouble speaking, chewing, or swallowing due to the lesion
• Pain or discomfort associated with the lesion

Preparation

• Fasting for at least 6 hours prior to the procedure
• Adjustment or cessation of certain medications as advised by the doctor
• Imaging studies or biopsies to assess the lesion
• A full medical evaluation to ensure readiness for surgery

Procedure Description

1. The patient will receive local anesthesia to numb the tongue.
2. A surgical incision is made around the lesion.
3. The lesion is carefully excised, ensuring clear margins are obtained if malignancy is suspected.
4. A local flap of healthy tongue tissue is created and rotated or moved to cover and close the surgical wound.
5. The flap is sutured into place to facilitate healing.

The procedure commonly involves specialized surgical instruments such as scalpels, forceps, and suture materials.

Duration

The procedure typically lasts between 1 to 2 hours depending on the complexity and size of the lesion.

Setting

This procedure is usually performed in a hospital or outpatient surgical center.

Personnel

• The procedure is primarily conducted by an oral surgeon or an otolaryngologist (ENT specialist).
• An anesthesiologist or nurse anesthetist may be involved for local anesthesia administration and monitoring.
• Surgical nurses assist during the procedure.

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Swelling or bruising
• Pain and discomfort
• Adverse reactions to anesthesia
• Scarring or changes in tongue function
• Rarely, recurrence of the lesion

Benefits

• Removal of the lesion prevents potential progression, especially in cases of malignancy.
• Alleviation of symptoms such as pain or difficulty with oral functions.
• Improved oral health and overall quality of life.

Recovery

• Patients can usually go home the same day but should arrange for someone to drive them.
• Pain management might include prescribed medications.
• Avoidance of certain foods and activities that may irritate the surgical site.
• Follow-up appointments to monitor healing and ensure no complications arise.
• Full recovery typically occurs within a few weeks, with initial discomfort and swelling subsiding within a few days.

Alternatives

• Monitoring the lesion with regular check-ups if it is benign and asymptomatic
• Non-surgical treatments such as radiation or chemotherapy for malignant lesions
• Cryotherapy or laser ablation in certain cases

Each alternative has its own set of pros and cons and should be discussed thoroughly with the healthcare provider.

Patient Experience

During the procedure, the patient will be awake but should not feel pain due to local anesthesia. Afterward, there will be some discomfort and swelling managed with pain relief measures. The patient may have dietary restrictions and activity limitations during the healing process, with a gradual return to normal functions.