Partial Midline Glossectomy

Partial midline glossectomy involves the removal of a segment of muscle at the back of the tongue. When performing a lingual tonsillectomy the tongue muscle is entwined in the lingual tonsil tissue. Almost invariably, partial midline glossectomy is performed during a lingual tonsillectomy. This does not add to the post-operative recovery. The area that is being excised does not affect tongue movements or taste. The goal of removing tissue in the midline is to create a trough through which air can flow. A pre-operative x-ray helps to determine whether additional tongue muscle needs to be removed.

The side effects from partial midline glossectomy are the same as for lingual tonsillectomy. This includes pain lasting up to several weeks requiring strong pain medications.. In addition, there may be an altered sense of taste that can last for months. There may be a short period when speech may be altered. Patients also describe ear pain. Patients can expect to lose 15-20 pounds and can become dehydrated.

 

Patients are typically sent home with a regimen of oral liquid pain medications such as Roxicet or Roxicodone. Tablets include Percocet which can be crushed. Patients are often sent home with Dilaudid suppositories, anti-nausea medications such as Zofran and Prednisone to prevent post-operative swelling. Antibiotics are prescribed infrequently. Finally, mouth washes, such as Nystatin, are prescribed to prevent yeast infections and viscous lidocaine for topical pain management. Neurontin may be prescribed to help manage post-operative pain.