41112 Excision of lesion of tongue with closure; anterior two-thirds

Name of the Procedure:

Excision of Lesion of Tongue with Closure; Anterior Two-Thirds (Partial Glossectomy)

Summary

In this procedure, a surgeon removes a lesion (such as a tumor or abnormal tissue) from the front two-thirds of the tongue. The affected area is then surgically closed to promote healing and restore function.

Purpose

The procedure aims to treat or remove abnormal or cancerous growths on the tongue. Successful excision can prevent the spread of disease, alleviate symptoms, and improve oral function.

Indications

• Presence of a suspicious lesion or tumor on the tongue.
• Persistent sores or ulcers on the tongue not healing after treatment.
• Biopsy-proven tongue cancer.
• Precancerous dysplasia on the tongue.
• Patients with swallowing or speech difficulties due to the lesion.

Preparation

• Patients may be instructed to fast for at least 6-8 hours before the procedure.
• Medication adjustments, particularly blood thinners, as per doctor's guidance.
• Preoperative assessments, including blood tests, imaging studies (CT or MRI), and biopsy results.
• Consultation with an anesthesiologist.

Procedure Description

1. Anesthesia: General anesthesia is typically administered.
2. Accessing the Lesion: The surgeon carefully isolates the front two-thirds of the tongue.
3. Excision: The lesion, along with a margin of healthy tissue, is excised.
4. Closure: The excision site is closed using sutures.
5. Hemostasis: Ensuring any bleeding is controlled.
6. Postoperative Checks: Verification of effective closure and no immediate complications.

Tools and equipment might include surgical scalpels, suturing instruments, and hemostatic agents.

Duration

The procedure typically takes 1 to 2 hours, depending on the lesion’s size and complexity.

Setting

This surgery is usually performed in a hospital's operating theatre or a specialized surgical center.

Personnel

• Oral and Maxillofacial Surgeon or Head and Neck Surgeon.
• Anesthesia team, including an anesthesiologist and nurse anesthetist.
• Surgical nurses and support staff.

Risks and Complications

• Common Risks:
  • Bleeding
  • Infection
  • Pain and swelling
• Rare Complications:
  • Nerve damage leading to changes in sensation or taste
  • Difficulty in speaking or swallowing
  • Recurrence of the lesion
  • Adverse reactions to anesthesia

Benefits

• Expected Benefits:
  • Removal of potentially malignant lesions.
  • Prevention of disease spread.
  • Relief from associated symptoms like pain and difficulty in swallowing.
• Time to Realize Benefits:
  • Benefits are typically noted shortly after recovery from anesthesia but complete healing may take several weeks.

Recovery

• Post-procedure, patients might experience swelling and discomfort, managed with pain relief medications.
• Liquid or soft diet is recommended initially.
• Patients might need speech or swallowing therapy.
• Follow-up appointments are essential for monitoring healing and early detection of any recurrence.
• Recovery time varies but typically ranges from 2 to 4 weeks.

Alternatives

• Non-Surgical Treatments: Radiation therapy, chemotherapy, or combinations thereof.
• Pros and Cons:
  • Non-surgical treatments can be less invasive but might not be suitable for all types of lesions.
  • Surgery provides immediate physical removal but involves recovery time and surgical risks.

Patient Experience

• During the Procedure:
  • Patients will be under general anesthesia and feel no pain.
• After the Procedure:
  • Swelling, discomfort, and altered speaking or eating may be experienced.
  • Pain management includes prescribed analgesics.
  • The care team ensures comfort through postoperative support and instructions on handling side effects.