Glossectomy; hemiglossectomy
CPT4 code
Name of the Procedure:
Glossectomy; Hemiglossectomy
Summary
A glossectomy is a surgical procedure to remove part or all of the tongue. A hemiglossectomy specifically involves the removal of one side of the tongue. This procedure is typically performed to treat tongue cancer or other severe diseases affecting the tongue.
Purpose
A glossectomy addresses conditions such as tongue cancer, which can interfere with speech, swallowing, and other vital functions. The goal is to remove malignant tissue while preserving as much function as possible.
Indications
- Diagnosis of tongue cancer
- Severe trauma to the tongue
- Persistent disease or infection resistant to other treatments Patients typically exhibit symptoms such as persistent tongue ulcers, pain, bleeding, or noticeable lumps.
Preparation
Pre-procedure instructions may include:
- Fasting for 8-12 hours prior to surgery
- Adjustments to current medications as advised by the doctor
- Pre-operative diagnostic tests like imaging scans and biopsies
Procedure Description
- Anesthesia: General anesthesia is administered.
- Incision: An incision is made in the affected area.
- Tissue Removal: The surgeon removes part (hemiglossectomy) or all (total glossectomy) of the tongue.
- Reconstruction: In some cases, reconstructive surgery using tissue grafts may be performed to restore functionality.
- Closure: The incision is closed with sutures. Tools used include surgical scalpels, cauterizing tools, and possibly a laser.
Duration
The procedure typically takes 1-3 hours, depending on the extent of the surgery and any reconstruction required.
Setting
This surgery is usually performed in a hospital operating room.
Personnel
- Surgeon specialized in head and neck or oral surgery
- Anesthesiologist
- Surgical nurses
- Possibly a reconstructive/plastic surgeon
Risks and Complications
Common risks:
- Infection
- Bleeding
- Swelling
- Pain Rare complications:
- Difficulty speaking or swallowing
- Nerve damage
- Adverse reaction to anesthesia
Benefits
The primary benefit is the removal of cancerous tissue, potentially leading to a cancer-free state. Improved quality of life is expected as the procedure aims to alleviate symptoms caused by the malignancy.
Recovery
- Hospital stay of several days is common.
- Pain management with prescribed medication.
- Speech and swallowing therapy may be necessary.
- Full recovery may take several weeks to months.
- Follow-up appointments for monitoring healing and function.
Alternatives
- Radiation therapy: Less invasive but may not be as effective in advanced cancer stages.
- Chemotherapy: Used in conjunction with radiation or surgery but has systemic side effects.
- Partial glossectomy: Involves removing a smaller portion of the tongue.
Patient Experience
Patients can expect a hospital stay post-surgery. Initial discomfort, pain, and difficulty speaking and swallowing are common. Pain management will be provided, and supportive care includes speech therapy and soft diet adjustments as they heal.