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INFORMATION ABOUT GLOSSECTOMY

Information for patients and carers

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document please contact us on 020 3447 9755. We will try

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Head & Neck Centre

Contents

1 Introduction .............................................................. 3 3 Why is it done? ........................................................ 3

Page No.

2 What is a glossectomy? .......................................... 3 4 What does it involve? .............................................. 3

5 Are there any alternatives to this surgery? .............. 4 7 What can I expect after the operation? .................... 4 9 What can I expect after discharge from hospital? .... 8 11 Where can I get further information?........................ 9 8 What are the risks? .................................................. 6 6 What can I expect before the operation? ................ 4

10 Contact details.......................................................... 9

1 Introduction

This leaflet has been written to help you understand your forthcoming treatment and contains answers to many of the common questions. If you have any other questions that the leaflet does not answer or would like further explanation please ask your surgeon.

2 What is a glossectomy?

A total glossectomy is the surgical removal of more than glossectomy is removal of less than half your tongue. half your tongue, usually the entire tongue. A partial

3 Why is it done?

A glossectomy is performed to treat cancer of the tongue.

4 What does it involve?

anaesthesia. This surgery may be performed by a surgical laser technique or by an incision made with a scalpel. removed and a skin flap is required to fill the area a the tongue immediately. If a larger portion of the tongue is the wrist together with the blood vessels that supply it. separate leaflet). common approach is to use a piece of skin taken from A partial glossectomy is commonly repaired by sewing up

Glossectomies are always performed under general

This type of graft is called a radial forearm free flap (see

5 Are there any alternatives to this surgery?

There may be other treatments for cancer of the tongue but your medical team will be suggesting this one as team will be happy to discuss the reasons for may have. thought to be the most appropriate for you. Your medical recommending this operation and any other concerns you

6 What can I expect before the operation?

pre assessment appointments will also be carried out. These will involve seeing the doctor, anaesthetist, pre admission nurse, clinical nurse specialist, speech and

the surgery with you. Following meeting with the doctors

At your preoperative appointment the doctors will discuss

the nurse or anaesthetist when to stop eating and drinking so you can fast before your operation.

At your pre-assessment appointment you will be told by

you may have.

This also gives you an opportunity to ask any questions

bloods, chest X-rays and ECGs may also be performed.

language therapist and dietitian. Routine tests for example

7 What can I expect after the operation?

After a total glossectomy, you will usually remain in the

hospital for 8 to 10 days. After a partial glossectomy you

will usually remain in the hospital for 4-5 days. This is an

estimate as factors such as your general health, previous You may spend the first 24 48 hours after the operation on the intensive care unit before returning to the ward. the surgery and will be closely monitored by

treatment, or wound healing may alter your length of stay.

You may need oxygen in the first 2448 hours after

nursing staff. Oxygen is administered through a If you are having a flap you may have a

facemask or two small tubes placed in the nostrils.

the stomach. (PEG tube). The dietitians will discuss eating and drinking the dietitian will advise you on this with you before your operation. When you start

tube passed through the wall of you abdomen into

nose to the stomach (nasogastric, NG tube) or via a

given nutrition through a tube that goes from the

Until you are able to take food by mouth, you will be

your breathing (see separate leaflet).

tracheostomy inserted into your windpipe to aid

given via the feeding tube. This may happen in hospital.

how to adapt your diet, and manage what is being hospital or when you have been discharged from

You may have drains collecting fluid from the hours post op.

operation site. These are usually removed 48-72 You may have a urinary catheter to collect your

urine. This will be removed once you are mobile you are passing.

and the doctors are happy with the amount of urine

You may experience some pain after the operation. You may have a PCA (patient controlled analgesia) yourself pain killers via an infusion set up in system which enables you to press a button to give theatres. There is a system within the infusion to

ensure you do not give yourself too much painkiller too quickly so it is safe to use. This will be only for 24-48 hours post operatively then you will be able

will also be given pain killers to take home to use as you continue to recover.

to have pain killers via mouth or NG/PEG tube. You

8 What are the risks?

complications specific to this type of surgery are:

and these will be discussed with you by the doctor. Other

As with any surgery there is always be risk of complications

A fistula may form. This is a passage between the the first two weeks following a glossectomy. skin and the mouth cavity & usually occurs within

Patients who have had previous anti cancer

Though care is taken to repair the tongue so as to maintain its mobility and aiming to replace your

treatments may find their healing process is slower.

depends on how much of the tongue is removed.

swallowing in the long term. This complication

experience changes with speech and problems with

not always successful. It is still possible to

speech and swallow to as normal as possible this is

You will receive information and advice regarding the dietitian before and after your operation.

this from the speech and language therapists and

inflammation leading to blockage of the airway. Flap failure this complication is often due to problems with the flaps blood supply please see

complication of surgery; it can result in severe

Bleeding from the tongue. This is an early

separate leaflet re flap for more details.

9 What can I expect after discharge from hospital?

their district nurse. If you do need extra care the ward medication and dressings to take home with you.

Most people go home without needing ongoing care from nurses will plan this with the district nurses. You will be given any letters for your district nurse and GP as well as

You will be given an outpatient appointment to see your you if it is available. At this time the doctors will also

medical team about 14 days after discharge. At this time the results of the pathology report will be discussed with or not. If no further treatment is needed at this time after discuss with you whether you require any further treatment appointments so the doctors can monitor your progress. nurse specialist) to continue your rehabilitation.

this appointment you will be given monthly outpatient

example speech and language therapist, dietitian, clinical

You may also need to see other members of the team (for

There is also a support group which you can join to meet others who have been through a similar experience. Please ask your clinical nurse specialist for more information if this interests you.

10 Contact numbers

healthcare professional secretary on 020 3447 9755. Your message will be taken and passed onto the appropriate department. UCLH Head and Neck Cancer Centre

If you have any questions please contact the appropriate

1st Floor East London NW1 2PG

250 Euston Road headandneckcentre@uclh.nhs.uk

11 Where can I get further information?

Macmillan Cancer Support

If you would like more information you can also contact a cancer support organisation such as:
89 Albert Embankment, London, SE1 7UQ 0808 808 2020 9am-9pm, Monday to Friday

cancer and provide practical and emotional support. email cancerline@macmillan.org.uk

Trained advisers can answer questions about living with

Cancer information nurse specialists can answer questions Website: www.macmillan.org.uk a diagnosis.

0808 800 1234 9am-8pm Monday to Friday

about cancer types, treatment and what to expect following

Features information about living with cancer, Macmillans services and online communities in which people affected by cancer can share experiences and support. Also information about cancer types and treatment. an interpreter. includes a link to www.cancerbacup.org.uk for detailed

Friday for other languages, call 0808 800 1234 and ask for

Information is also available for free, 9am-9pm Monday to

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Space for notes and questions

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Patient Information leaflet produced by the staff, patients and carers associated with the UCLH Hospital
Publication date: May 2009 Date last reviewed: May 2011 Date next review due: May 2013 Leaflet code: UCLH/CS/H&N/CNS/CR/1

University College London Hospitals NHS Foundation Trust

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