Side Effects After Tongue Base Growth Removal
Patients undergoing surgical removal of a growth at the base of the tongue should expect temporary swallowing difficulties (dysphagia) and pain with swallowing (odynophagia) as the most common side effects, with most swallowing abnormalities resolving within 4 weeks, though 30% may experience persistent issues for 6-19 months postoperatively. 1, 2, 3
Common Early Postoperative Complications
Swallowing and Speech Problems
- Dysphagia (difficulty swallowing) occurs commonly but typically resolves within 4 weeks, representing the most frequent functional complaint after tongue base surgery 3
- Odynophagia (painful swallowing) is expected in the immediate postoperative period 1, 2
- Self-limited aspiration may occur during the immediate postoperative period but generally resolves without long-term sequelae 3
- Temporary articulation distortions and speech impairment have been reported but are not permanent 1, 3
- Three out of 10 patients (30%) experienced swallowing abnormalities 6-19 months postoperatively, though all were able to resume a normal diet 1
Airway and Secretion Management
- Significant postoperative pharyngolaryngeal edema and increased secretions can compromise the airway, particularly in the first 24-48 hours 2
- Hypersalivation may require pharmacologic management with glycopyrrolate (0.2-0.4 mg IV or subcutaneously every 4 hours as needed) 2
- Some extensive procedures may require temporary tracheotomy due to risk of airway compromise 1, 2
Local Wound Complications
- Hematomas and seromas represent common local complications that typically resolve with conservative management 3
- Floor of mouth infections can occur and require vigilant monitoring 2
- Disturbances of wound healing occur but are generally manageable 3
Serious but Rare Complications
Infectious Complications
- Tongue base abscess formation is a potentially serious complication that can occur from retained suture material or infection 2, 4, 5
- Submental abscess has been reported, particularly when non-absorbable sutures are used 1
- Floor of mouth sialadenitis (salivary gland inflammation) can develop 1
- Development of floor of mouth cyst has been reported 1
Sensory and Motor Deficits
- Decreased sensitivity of the chin and tongue can occur with more extensive procedures 1
- Tongue immobility has been reported with certain aggressive techniques 1
- Decreased sense of taste may develop 1
- Persistent tongue edema can occur 1
Long-Term Outcomes
Functional Recovery
- No persistent voice changes or dysphagia were reported in patients undergoing uncomplicated tongue base procedures 3
- Permanent disabilities are rare when the procedure is performed correctly, with most complications being temporary 3
- The extent of tongue base removal significantly impacts swallowing function—extensive removal of the tongue base is significantly related to poor swallowing outcomes 6
Critical Monitoring Points
Immediate Postoperative Period (24-48 hours)
- Monitor for airway compromise from combined edema and excessive secretions 2
- Assess for signs of infection (fever, increased pain, swelling) 2
- Evaluate swallowing function before oral intake 3
Extended Recovery (Weeks to Months)
- 23% of patients complained of postoperative complications at long-term follow-up (98 months post-operatively) 1
- Swallowing abnormalities may persist for 6-19 months but typically allow resumption of normal diet 1, 2
- Speech and articulation typically normalize over time 1, 3
Procedure-Specific Considerations
The severity and type of side effects depend heavily on the extent of tissue removal:
- Minor procedures (lingual tonsillectomy, small lesion removal): Generally well-tolerated with minimal long-term effects 1
- Moderate procedures (partial tongue base reduction): Temporary dysphagia and speech changes expected 1
- Extensive procedures (near-total or total glossectomy): Significant risk of persistent swallowing dysfunction and potential need for alternative feeding methods 6