A glossectomy is a procedure to surgically remove parts of the tongue, most often to treat tongue cancer.

What is a glossectomy?

A glossectomy is a surgical procedure done under general anesthesia to remove tumors of the tongue. There are three types of glossectomies, which vary depending on the extent of the tumor: 

• Partial glossectomy: This entails removal of the tumor and a cuff of normal tongue to ensure complete removal of the tumor and negative pathologic margins. It usually means removal of up to one-third of the tongue, the exact extent of which depends upon the tumor.  
• Hemiglossectomy: This also involves removal of the tumor and a cuff of normal tongue to ensure complete removal of the tumor and negative pathologic margins, but it requires removal of half of the normal oral tongue. The surgeon will remove the diseased half of the tongue. Often, reconstructive surgery accompanies this type of operation to help restore the bulk and function of the tongue.
• Total glossectomy: During this surgery, the tongue is completely removed due to tumors that encompass the majority of the tongue. Reconstructive surgery is necessary to rebuild it by using tissue from elsewhere in the patient’s body. 

Since the tongue is close to other critical structures, including the jaw bone and floor of the mouth, a glossectomy may be a portion of a more complex surgery that involves other parts of the body (known as composite surgery). A tracheostomy may also be performed to assist patients with postoperative breathing. Reconstructive surgery may be required to help restore function and appearance. 

When is a glossectomy needed?

A glossectomy is usually performed to remove benign or cancerous tumors, also called neoplasms. The goal is typically curative, and a glossectomy is the recommended first-line treatment for the majority of oral cancers. 

Preparing for a Glossectomy

Johns Hopkins recommends meeting with a multidisciplinary team (made up of surgeons, a speech-language pathologist and experts in radiation oncology and medical oncology) to discuss your condition and treatment options. Before a glossectomy is performed, your team will conduct a physical examination. Often, imaging tests such as MRI or CT scans will be performed to give your physician important information in making a diagnosis and planning a course of treatment. A biopsy will also be performed on the tongue. The care team will provide preoperative instructions.

Possible Glossectomy Side Effects

• Swallowing difficulty 
• Pain
• Cancer recurrence
• Infection
• Bleeding
• Difficulty speaking or loss of speech
• Difficulty moving tongue
• Loss or partial loss of taste
• Weakness of the tongue

Recovery from a Glossectomy

Patients recover at different rates. For partial glossectomies, patients can often go home the same day. For more advanced surgeries that require reconstruction, patients typically stay in the hospital for seven to 10 days after surgery. Ultimately, recovery depends on the type of glossectomy performed or how much of the tongue was removed and how much reconstruction was needed. During this time, it’s normal to experience a decrease in tongue sensation and movement. A feeding tube may be needed to assist with eating and hydration.

Patients often complain of pain for a few weeks after surgery.

Attention to oral hygiene during recovery is important to reduce the risk of infection. A member of your care team will explain how to keep the mouth clean.

In some cases, health-care professionals may propose radiation therapy to kill any leftover cancer cells. Patients may also be limited to a diet of liquids or soft foods to prevent further damage during recovery. People who have had a total glossectomy may lose their ability to swallow and/or speak. Your physician will explain what to expect.

Speaking and Swallowing After a Glossectomy

Patients will work with a speech-language pathologist to resolve any language impairment and swallowing issues. Those who have had a total glossectomy will need to use a tablet or pen and paper to communicate. 

When should I contact my doctor?

After a glossectomy, contact your doctor if you experience any of these conditions:

• Loss of ability to eat or drink
• Nausea or vomiting
• Fever or other signs of infection
• Excessive bleeding
• Swallowing difficulties
• Choking
• Severe pain