41135 Glossectomy; partial, with unilateral radical neck dissection

Name of the Procedure:

Glossectomy; Partial with Unilateral Radical Neck Dissection

Summary

A partial glossectomy with unilateral radical neck dissection is a surgical procedure that involves removing a part of the tongue along with lymph nodes and possibly other structures on one side of the neck. This is often performed to treat certain types of oral cancer.

Purpose

The procedure is aimed at removing cancerous tissue from the tongue and reducing the risk of cancer spreading to the lymph nodes and other nearby structures. It is designed to improve survival rates and decrease the likelihood of cancer recurrence.

Indications

• Diagnosed cancer of the tongue, particularly when the cancer is localized.
• Presence of suspicious lymph nodes in the neck.
• Failure of other treatments like radiotherapy or chemotherapy.
• Patients in good overall health who can withstand surgery.

Preparation

• Fasting for at least 8 hours before the surgery.
• Adjustments in medications as directed by the healthcare provider.
• Preoperative imaging studies (e.g., MRI, CT scans) and lab tests.
• Discussion of the procedure, risks, and post-operative care with the surgical team.

Procedure Description

1. Administration of general anesthesia to ensure the patient is asleep and pain-free.
2. An incision is made in the mouth to access the tongue and remove the affected portion.
3. A neck incision is then made to perform unilateral radical neck dissection, which involves removing lymph nodes and possibly surrounding tissues and muscles.
4. In some cases, reconstructive surgery may be needed to ensure proper function and appearance.
5. Wound closure with sutures or staples.

Duration

The procedure typically takes 3 to 6 hours, depending on the extent of the surgery and complexities involved.

Setting

This procedure is performed in a hospital operating room.

Personnel

• Head and neck surgeon
• Surgical assistants
• Anesthesiologist
• Operating room nurses
• Possibly a reconstructive/plastic surgeon

Risks and Complications

• Infection at the site of surgery
• Bleeding and blood clots
• Difficulty swallowing and speaking
• Nerve injury, which may affect shoulder movement or sensation
• Complications from anesthesia
• Swelling of the airway

Benefits

• Removal of cancerous tissue, leading to reduced risk of cancer spread.
• Potentially increased survival rate.
• Prevention of cancer recurrence in treated areas.
• Patients might notice improvements in symptoms within weeks post-surgery.

Recovery

• Hospital stay for a few days post-surgery.
• Wound care and management of surgical drains if placed.
• Pain management with medications.
• Nutritional support, possibly through a feeding tube initially.
• Speech and swallowing therapy may be necessary.
• Follow-up appointments for monitoring recovery and further treatment if needed.
• Full recovery may take a few weeks to several months, depending on individual cases.

Alternatives

• Radiation therapy: Less invasive but may not be as effective for certain cancer stages.
• Chemotherapy: Used alone or with radiation but may have more systemic side effects.
• Targeted therapy: Suitable for specific cancer types but not universally applicable.
• Palliative care: Focuses on symptom management rather than curative intent, suitable for advanced cancer stages.

Patient Experience

During the procedure, patients are under general anesthesia and will not feel anything. Post-surgery, patients may experience pain, difficulty swallowing, and speaking issues, which will be managed with pain medications and supportive therapies. Discomfort and swelling are common initially but will gradually improve. Support from healthcare providers, including speech and swallowing therapists, will be available to assist in recovery.