For some sleep apneic patients and snorers, the tongue may fall back during sleep causing obstruction and snoring. If this obstruction is significant, you may be recommended reduction of the base of tongue. One technique is called a midline glossectomy.
A midline glossectomy is performed in the operating room while you are asleep without any incisions. Using a variety of methods the middle (“midline”) and back portion of the tongue is reduced. Care is taken so not to affect your speech or swallowing functions.
Often times a midline glossectomy is performed with Palatal (Oropharyngeal) Reconstruction at the same time.
Typically as a stand-alone procedure, there is some discomfort associated with a midline glossectomy. However, a midline glossectomy is not as uncomfortable as removal of the tonsils and soft palate. If you are also undergoing a tonsillectomy or soft palate reconstruction the midline glossectomy should not add significant discomfort to the procedure.
Regardless, you will be prescribed pain medication either from our office or from a referral to a pain specialist.
The mid portion of the tongue may be reduced with minimal change in swallowing function. For the most part, once healing is achieved swallowing will be normal.
No. The creation of your voice begins in the voice box while resonance is a function the back of the nose. The tongue and lips participate in articulation but it is the front of the tongue that is functional in speech. Therefore, a midline glossectomy has very little effect in voice.
You will be on a soft diet for 10-14 days while your throat and base of tongue heals to avoid bleeding. For most you should anticipate a 5-15 lb. weight loss. It is important to maintain your fluid and electrolyte intake while healing to avoid dehydration. Dehydration is the number one cause of increased pain as well as complications after surgery.
Midline glossectomy is a safe and proven method to reduce the size of the back of the tongue. Complications are rather rare. The number one complication (<1%) would be bleeding. If this occurs you may require a visit to the operating room to “buzz” the bleeder.
Functional complications (numbness, swallowing, and voice changes) are exceedingly rare. Care is taken to avoid the nerves and vessels that supply the tongue. Injury to these vessels could compromise function.
As with any sleep apnea procedure failure is a possibility, as no guarantee can be made for any snoring/sleep apnea procedure. A more comprehensive list of potential complications will be discussed in the office.