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Hemiglossectomy


Medical editor Per Aspelien MD
Otolaryngologist
Oslo University Hospital

General

If tumor is located on the tongue, a tongue resection may be necessary. Depending on the size of the tumor, a partial resection or hemiglossectomy is performed. This means that parts or half of the tongue are resected.

If the mandible cannot be covered with primary sutures of mucosa, a nasolabial flap is used for coverage. This means that skin and subcutaneous tissue flap is dissected from underlying facial muscles (1). A hole is made in the cheek to the mouth and the skin flap is pulled through and sutured to the edges of the mucosa .

Indication

  • Tongue cancer

Goal

  • Curative resection

 

1. Reference: Rökenes HK, Bretteville G, Lövdal O, Boysen M. The nasolabial skinflap in intraoral reconstruction. ORL J Otorhinolaryngol Realt Spec 1991; 53 (6): 346-8


Equipment

  • Large basic tray (nr. 9)
  • Bent Colorado blades
  • Hook
  • Mouth block

Preparation

  • The surgery is performed under general anesthesia.
  • The patient lies in a supine position.

Implementation

  • With a diathermy needle, about a 1 cm margin is marked around the tumor.
  • Xylocain® with adrenaline is given.
  • The affected area of the tongue is resected and possibly some of the floor of the mouth. 
  • The resection border is inspected for remaining tumor tissue. 
  • If there are suspect areas, a frozen section is made.
  • If the mandible is exposed, it is covered. A nasolabial flap may be used.
  • The wound is usually left open for granulation. It may possibly be closed with widely spaced sutures.
  • The surgeon will attempt to preserve the lingual and hypoglossal nerves. 
  • Larger arteries are ligated. 
  • The specimen is oriented for a histological evaluation. 

Follow-up

A tube is inserted as needed.

If a nasolabial flap is made, the patient will have a feeding tube for a few weeks until the flap has healed to the edge of the mucosa and bone. The flap is then docked after about 3 weeks.

The patient will have a follow-up visit with the surgeon after a few weeks.


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