Tongue Base Surgery

Many sleep specialists concur that the obstruction behind the tongue is a key factor in obstructive sleep apnea (OSA) for many adults. Recent data indicates that, for some patients, more favorable results are attained by addressing this area surgically, along with the nasal cavity and palate. Surgical interventions can aim to make the tongue more stable and resistant to collapse during sleep or may involve removing tongue tissue to reduce its volume in certain cases. Like any medical approach, thorough patient evaluation is crucial to ensure positive outcomes.

It is also a rare procedure to treat cancers of the base of the tongue. Such tumours are generally related to HPV (human papillomavirus). 

What is Tongue Base Surgery?

Tongue Base Surgery is a surgical procedure designed to address cancers or obstructions in the area behind the tongue. In terms of cancer surgery, the tumour is removed along with a cuff of normal tissue. Removal of a cuff of normal tissue is an advanced procedure and it is done to ensure complete surgical removal and prevent disease recurrence. 

In terms of OSA, this region is recognized as a significant contributor to obstructive sleep apnea (OSA) in many adult patients. The surgery aims to enhance the airflow during sleep by making the tongue more stable, less collapsible, or by reducing its volume.The procedure may involve various techniques, such as stiffening the tongue to prevent collapse or removing excess tissue to decrease its size. The goal is to create an unobstructed air passage, thereby reducing the symptoms of sleep apnea.

It’s essential to note that the decision to undergo Tongue Base Surgery is based on individual patient evaluations. Sleep specialists assess the specific factors contributing to sleep apnea and determine whether surgical intervention in the tongue base area, in addition to addressing other potential obstructions like the nasal cavity and palate, would be beneficial.

As with any medical procedure, the success of Tongue Base Surgery in alleviating sleep apnea symptoms relies on a careful and thorough evaluation of the patient’s condition. The goal is to improve the quality of sleep and overall well-being by addressing the underlying causes of obstructive sleep apnea.

Types of Tongue Surgery

 Let’s break down these two types of tongue surgeries:

• Lingual Tonsillectomy: This surgery involves removing or reducing the size of the lingual tonsils, which are located at the base of the tongue. Lingual tonsillectomy is typically performed to address obstructions or issues related to the lingual tonsils that might contribute to conditions such as sleep apnea.

• Genioglossus Advancement: Genioglossus advancement is a surgical procedure that involves repositioning and advancing the genioglossus muscle, which is part of the tongue. This surgery is often performed to address obstructive sleep apnea. By repositioning the genioglossus muscle, the goal is to prevent its collapse during sleep, helping to keep the airway open and reducing the likelihood of breathing interruptions.

• Tongue base resection : This is an advanced procedure used to treat tumors and cancers at this location. It may also entail removal of lymph nodes in the neck. 

These types of tongue surgeries are part of the broader field of surgical interventions for sleep-related breathing disorders, particularly obstructive sleep apnea. The specific choice of surgery depends on the individual patient’s condition and the underlying factors contributing to their sleep apnea symptoms. As with any medical procedure, careful evaluation and consultation with healthcare professionals are essential to determine the most suitable approach for each patient.

Common Methods in Tongue Surgery (Sleep Apnea)

The specific techniques and procedures for Tongue Base Surgery (TBS) can vary, but the general goal is to address obstructions in the area behind the tongue, which contribute to obstructive sleep apnea (OSA). Here is an overview of how Tongue Base Surgery for sleep apnea is typically performed:

• Anesthesia:

Tongue Base Surgery is usually performed under general anesthesia, ensuring the patient is completely asleep and pain-free during the procedure.

• Access to the Tongue Base:

Depending on the specific surgical approach, access to the tongue base is gained through the mouth. This may involve using specialized tools and instruments.

• Surgical Techniques:
• The surgeon may employ various techniques to address obstructions in the tongue base:
• Tongue Stiffening: Making the tongue firmer to prevent collapse during sleep.
• Tongue Reduction: Removing excess tissue to reduce the volume of the tongue.
• Repositioning: Adjusting the position of specific tongue muscles, like the genioglossus muscle.

It’s crucial to note that the decision to undergo Tongue Base Surgery is based on individualized assessments, and the specific surgical techniques may vary based on the patient’s condition and the surgeon’s approach. 

Additionally, advancements in surgical technologies and techniques continue to shape and refine how Tongue Base Surgery is performed for sleep apnea. If considering this surgery, detailed discussions with healthcare professionals will provide a clearer understanding of the personalized approach and expected outcomes.

After Tongue Surgery – Guidelines for Recovery

After undergoing tongue surgery, it’s common to experience taste abnormalities, swallowing difficulty, and temporary numbness in the tongue. These symptoms are typically temporary, with permanent occurrences being rare.

Pain Management:

Expect varying degrees of pain after tongue base surgeries. You’ll receive prescription pain medication, and it’s crucial to take it as directed to manage discomfort effectively. Pain may persist for 7-14 days post-surgery, improving around the two-week mark. If you’re running low on medication and still experiencing significant pain, reach out to us before it’s finished.

Dietary Considerations:

Due to pain and swallowing challenges, sticking to a liquid or soft diet (like Ensure or smoothies) during the initial days post-surgery is advised. Ensure proper fluid intake to prevent dehydration. You should be able to transition to a normal diet around 14 days after surgery. Avoid hard and dry foods during this recovery period, as they may cause pain and increase the risk of bleeding.

Physical Activity:

Refrain from strenuous physical activity for the first three weeks. While it’s essential to move around to prevent complications, strenuous activities can lead to increased swelling or bleeding.

Bleeding Episodes:

Minor bleeding may occur post-surgery. If bleeding persists or exceeds approximately half a cup, seek immediate medical attention. Visit Stanford’s Emergency Department or the nearest emergency department if you’re not in close proximity.

Sleeping Position:

Elevate your head at an angle of 30-45 degrees when sleeping. This helps reduce swelling and improves breathing following palate surgery.

Remember, these guidelines are essential for a smooth recovery. If you have any concerns or experience unusual symptoms, don’t hesitate to reach out for assistance.