تعريف
A glossectomy is the surgical removal of all or part of the tongue. The surgery may be:
- Partial—removal of part of the tongue
- Hemi—one side of the tongue is removed
- Total—removal of the whole tongue
أسباب هذا الإجراء
This surgery is used to treat tongue cancer. It is done when other treatments have not been successful.
المضاعفات المحتملة
No procedure is completely free of risk. If you are planning to have glossectomy, your doctor will review a list of possible complications, which may include:
- Tongue bleeding
- العدوى
- Airway blockage from swelling and bleeding
- Trouble swallowing and aspiration of liquids
- Being unable to speak
- فقدان الوزن
- Failure of flap—occurs when transplanted skin or flap does not get enough blood flow
- Recurrence of cancer
بعض العوامل التي قد تزيد من خطر المضاعفات تشمل:
- أمراض الرئة
- Large tumors
- سوء التغذية
- إدمان الكحول
- التدخين
- Prior radiation
- Prior chemotherapy
- مرض السكري
تأكد من مناقشة هذه المخاطر مع طبيبك قبل الجراحة.
ما يمكن توقعه
قبل الإجراء
قد يقوم طبيبك بما يلي:
- Blood work
- اختبار بدني
- Ask about your medical history, including whether you smoke or drink alcohol
- Biopsy of the tongue—a piece of tongue is removed and sent to a lab for testing to diagnose cancer
- X-ray or CT scan of the chest—tests that take a picture of structures inside the chest
- CT scan of the mouth and neck —a type of x-ray that uses a computer to make pictures of structures inside the body
قبل الجراحة:
- التحدث مع طبيبك عن الأدوية الخاصة بك. قد يطلب منك التوقف عن تناول بعض الأدوية تصل إلى أسبوع واحد قبل العملية مثل:
- الأدوية المضادة للالتهابات (مثل الأسبرين)
- سيولة الدم, مثل كلوبيدوجريل (بلافيكس) أو الوارفارين (الكومادين)
- رتب لتوصيلة من وإلى المستشفى.
- تناول وجبة خفيفة في الليلة السابقة. لا تأكل أو تشرب أي شيء بعد منتصف الليل.
- If you have diabetes, ask your doctor if you need to adjust your medicines.
التخدير
General anesthesia will be used. It will block any pain and keep you asleep through the surgery.
وصف الإجراء
You will have a tracheotomy to allow you to breathe during and after surgery. This creates an opening from the outside of your neck to your windpipe. A tube is inserted through the opening so that you can breathe. It is usually temporary.
If part of the tongue needs to be removed, the doctor will remove this cancerous section. The remaining area of the tongue will be sewn so that there is no hole. Sometimes, a small graft of skin will be used to fill the hole. This skin graft will then be sewn into place.
If the entire tongue needs to be removed, this is a more complicated surgery. The doctor will remove the diseased tongue. A piece of skin from your wrist will also be removed. This skin graft will be placed in the hole left by the tongue. Blood vessels will also be attached from any remaining tongue to the graft. This is to ensure blood flow. Sometimes the lymph nodes in the neck will also need to be removed.
كم من الوقت سيستغرق ؟
Several hours
كم هو مؤلم ؟
Anesthesia will prevent pain during the surgery. You will have pain during recovery. Ask your doctor about medicine to help with the pain.
متوسط الإقامة في المستشفى
7-10 days
رعاية ما بعد العملية
في المستشفى
While recovering at the hospital, you may receive the following care:
- Oxygen through prongs attached to your nose for the first 1-2 days
- Nutrition through a tube—Once you are able to swallow, you will be able to have drinks and pureed food. If a total glossectomy is done, you may need a permanent feeding tube in your stomach.
- Fluids and medicines will be given through an IV
- Special boots or sock to help prevent blood clots—You will also be encouraged to get out of bed as soon as possible.
- Instructions to breathe deeply and cough 10-20 times every hour (for the first few days)—This will decrease the risk of pneumonia.
In addition, your doctor may have you:
- Work with a speech therapist to learn to speak and swallow after surgery
- Begin radiation therapy to treat the cancer if it had not been given before
في البيت
عند العودة إلى المنزل ، قم بما يلي للمساعدة في ضمان التعافي السلس:
- Gargle several times a day to prevent infection.
- Take antibiotics as prescribed.
- Take pain medicine to ease discomfort.
- Slowly resume your normal diet.
- Continue to work with a speech therapist.
- تأكد من اتباع تعليمات طبيبك.
استدعاء الطبيب
بعد مغادرة المستشفى ، اتصل بطبيبك في حالة حدوث أي مما يلي:
- علامات الإصابة, بما في ذلك حمى وقشعريرة
- Difficulty swallowing or choking on food or liquids
- Swelling, excessive bleeding, or discharge from mouth
- ألم و / أو تورم في القدمين أو الساقين أو الساقين
- Problems with urination
- سعال ، ضيق تنفس ، ألم في الصدر ، غثيان أو قيء شديد
- زيادة الألم
- Any other worrisome symptom
في حالة الطوارئ ، اتصل على المساعدة الطبية على الفور.