Difference between revisions of "Glossectomy"
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{{Infobox surgical procedure | {{Infobox surgical procedure | ||
| anesthesia_type = | | anesthesia_type = General | ||
| airway = | | airway = Nasal ETT, Oral ETT | ||
| lines_access = | | lines_access = PIV | ||
| monitors = | | monitors = Standard, 5-lead ECG | ||
| considerations_preoperative = | | considerations_preoperative = History of head and neck radiation, airway history | ||
| considerations_intraoperative = | | considerations_intraoperative = Nasal intubation, adequate paralysis | ||
| considerations_postoperative = | | considerations_postoperative = | ||
}} | }} | ||
Glossectomy refers to surgical removal of part or all the tongue. It is primarily performed for excision of malignant lesions in addition to benign neoplasms of the tongue, obstructive sleep apnea, and macroglossia. Excisional or incisional biopsies of tongue lesions of undetermined etiology are also performed. | |||
There are several approaches to performing a glossectomy, most commonly transorally (through the mouth) for smaller and shallower tumors. Larger tumors or those with significant depth may require resection of the lower lip and mandible ("lip-split mandibulotomy"), or opening the sublingual or submental compartments for improved visualization of the inferior tongue ("transcervical pull-through"). Neck dissection and reconstruction are often performed for all glossectomy procedures. | |||
== Preoperative management == | == Preoperative management == | ||
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|Respiratory | |Respiratory | ||
| | |Mouth opening, mass obstruction of the airway, presence of trismus, tongue fixation | ||
|- | |- | ||
|Gastrointestinal | |Gastrointestinal | ||
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|Other | |Other | ||
| | |Consider preoperative flexible larynoscopy/imaging to assess tumor extension | ||
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Revision as of 14:10, 16 February 2022
| Anesthesia type |
General |
|---|---|
| Airway |
Nasal ETT, Oral ETT |
| Lines and access |
PIV |
| Monitors |
Standard, 5-lead ECG |
| Primary anesthetic considerations | |
| Preoperative |
History of head and neck radiation, airway history |
| Intraoperative |
Nasal intubation, adequate paralysis |
| Postoperative | |
| Article quality | |
| Editor rating | |
| User likes | 1 |
Glossectomy refers to surgical removal of part or all the tongue. It is primarily performed for excision of malignant lesions in addition to benign neoplasms of the tongue, obstructive sleep apnea, and macroglossia. Excisional or incisional biopsies of tongue lesions of undetermined etiology are also performed.
There are several approaches to performing a glossectomy, most commonly transorally (through the mouth) for smaller and shallower tumors. Larger tumors or those with significant depth may require resection of the lower lip and mandible ("lip-split mandibulotomy"), or opening the sublingual or submental compartments for improved visualization of the inferior tongue ("transcervical pull-through"). Neck dissection and reconstruction are often performed for all glossectomy procedures.
Preoperative management
Patient evaluation
| System | Considerations |
|---|---|
| Neurologic | |
| Cardiovascular | |
| Respiratory | Mouth opening, mass obstruction of the airway, presence of trismus, tongue fixation |
| Gastrointestinal | |
| Hematologic | |
| Renal | |
| Endocrine | |
| Other | Consider preoperative flexible larynoscopy/imaging to assess tumor extension |
Labs and studies
Operating room setup
Patient preparation and premedication
Regional and neuraxial techniques
Intraoperative management
Monitoring and access
Induction and airway management
Positioning
Maintenance and surgical considerations
Emergence
Postoperative management
Disposition
Pain management
Potential complications
Procedure variants
| Variant 1 | Variant 2 | |
|---|---|---|
| Unique considerations | ||
| Position | ||
| Surgical time | ||
| EBL | ||
| Postoperative disposition | ||
| Pain management | ||
| Potential complications |
References
Top contributors: Helen Heymann, Olivia Sutton and Chris Rishel