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Partial Glossectomy

Partial Glossectomy

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Preoperative Considerations

Consent:

  • Loss of taste, tongue mobility
  • Speech & swallowing difficulty

Anesthesia/Positioning:

  • Supine
  • Nasal tube
  • Paralysis is OK (may hold if concomitant neck dissection)

Other:

  • None

Armamentarium:

  • #15 / #10 blade
  • Monopolar & bipolar electrocautery
  • Small & medium vascular clips
  • Bite block
  • 2-0 silk or penetrating towel clamp for traction of tongue
  • Specimen cup
  • Armamentarium for neck dissectionn & local/free flap PRN

Technique

Postoperative Considerations

Immediate:

  • Speech & swallow assessment while inpatient

Follow Up:

  • Outpatient speech & swallow

Operative Note

Surgeon(s): ***

Assistant Surgeon(s):  ***

Preoperative Diagnosis: ***

Postoperative Diagnosis: Same

Procedure(s): ***

Anesthesia: General

Implants: None

Specimen:***

Drains: None

Fluids: See anesthesia record

EBL: Minimal

Complications: None

Counts:  Correct x2

Indications: ​***

Findings: As expected

Procedure in Detail:

The patient was seen in the preoperative holding area with a H&P was updated, consents were verified, surgical site marked, and all questions and concerns related to the proposed procedure were discussed in detail.  The patient was transferred to the operating room by the anesthesia team.  The patient underwent general anesthesia with endotracheal intubation. Tegaderms were placed over the eyes. The patient was prepped and draped in the standard fashion for maxillofacial procedures.  A time-out was performed and the procedure began.

The mouth was opened with a mouth gag, and the tongue was retracted laterally. A midline incision was made from the tip of the tongue to the base, exposing the tumor. Subsequently, using a Bovie electrocautery device, partial glossectomy was performed, meticulously excising the tumor with 1cm margins from visible tumor. The specimen was sent for histopathological examination. Frozen margins were negative. Hemostasis was achieved using the Bovie electrocautery, ensuring optimal control of bleeding throughout the procedure. The wound bed was irrigated with saline solution to remove any debris or residual tissue. Closure of the surgical site was meticulously performed using absorbable sutures, ensuring proper approximation of the tongue tissues without tension.

The patient's face was then cleaned and the posterior pharynx was suctioned. An OG tube was used to suction out the contents of the stomach. Tegaderms were removed from the eyes. Dressings were placed. The patient was then transferred back to the care of the anesthesia team for extubation and recovery.

Coding

ICD-10-CM (Diagnosis) Code:

  • C02.9 - Malignant neoplasm of tongue, unspecified
  • D37.01 - Neoplasm of uncertain behavior of tongue

CPT (Procedure) Code:

  • 41115 - Excision of tongue lesion
  • 41100 - Biopsy of tongue
  • 41105 - Excision of tongue lesion
  • 41116 - Partial glossectomy
  • 41130 - Total glossectomy
  • 42820 - Excision of lingual frenum (for biopsy)
  • 42825 - Excision of lingual frenum (for relief of ankyloglossia
  • 38740 - Radical neck dissection
  • 38745 - Radical neck dissection; bilateral
  • 38746 - Radical neck dissection; unilateral
  • 38747 - Radical neck dissection; ipsilateral limited
  • 38760 - Selective neck dissection (e.g., supraomohyoid, lateral)
  • 38765 - Modified radical neck dissection (e.g., for squamous cell carcinoma)

CDT (Dental) Code:

  • D7880 - Excision of lesion of oral tissue, including margins, unless otherwise specified, excluding biopsy of tissue
  • D7881 - Excision of hyperplastic tissue, per lesion
  • D7882 - Excision of pericoronal gingiva
  • D7883 - Excision of lesion of oral mucosa, hard palate, or maxillary tuberosity up to 1.25 cm
  • D7884 - Excision of tumor, lesion, or cyst of jawbones or related structures, by report

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