Glossectomy

Glossectomy

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	Comprehensive
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

Procedure variants

	Variant 1	Variant 2
Unique considerations
Position
Surgical time
EBL
Postoperative disposition
Pain management
Potential complications