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
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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