Recovery After Tongue and Oral Cavity Surgery

Recovery after tongue and oral cavity surgery is a process that varies from a few weeks to a few months depending on the extent of the operation. The recovery path after removal of a small tumour through the mouth differs from that after an extensive operation involving tissue reconstruction and neck dissection. This page describes what awaits you during this process and how you can support your recovery.

The first days in hospital

After small operations the hospital stay is short. After extensive operations, a stay of between several days and a few weeks may be needed to manage swelling and protect the newly reconstructed tissue. During this period:

• A temporary opening into the windpipe through the neck (tracheostomy) may have been made to keep the airway safe while there is swelling; it is closed as the swelling subsides.
• Until eating by mouth is safe, a thin feeding tube passing from the nose to the stomach may be used.
• The mouth is cleaned regularly with the recommended mouthwashes.
• Pain is managed with planned pain control and eases markedly after the first days.

Nutrition

To protect the stitches inside the mouth, the early period begins with liquid and pureed foods; as healing progresses, a soft diet and then normal eating follow. Adequate calorie and protein intake is important for the tissue to heal. If difficulty swallowing lasts a long time, the support of a swallowing therapist and a dietitian is used. You are advised to avoid very hot, spicy, acidic and hard foods until healing is complete.

Speech and swallowing

When part of the tongue or the floor of the mouth has been removed, speech may be hard to understand in the first weeks; it gradually improves as the swelling subsides and the tissue adapts. Speech and swallowing therapy both speeds the recovery of these functions and teaches practical methods for adapting to the new situation. Starting therapy early has a favourable effect on the outcome.

Oral care and mouth opening

• The teeth are brushed with a soft brush, without touching the suture line.
• The mouth is rinsed with the recommended mouthwashes after every meal.
• After surgery of the inner cheek or the back of the mouth, stiffness of the jaw muscles (trismus) may develop; regular mouth-opening exercises prevent this.
• Smoking and alcohol delay wound healing and increase the risk of recurrence; giving them up is the most important part of recovery.

If tissue reconstruction was performed

If reconstruction was performed with tissue taken from another part of the body (free tissue transfer or flap), both the new tissue inside the mouth and the area the tissue was taken from (forearm, thigh or leg) heal together. It is important to follow the instructions given about dressings and movement restrictions at the donor area. The colour and surface of the new tissue inside the mouth come to resemble the tissue of the mouth over time.

The longer term

If radiation therapy is planned after surgery, it usually begins within a few weeks once the wound has healed and brings its own care needs, such as dry mouth and dental care. Regular follow-up continues for years. If jaw or teeth have been lost, a dental prosthesis is planned once healing is complete.

When should you see a doctor?

• Increasing pain, redness, a bad smell or discharge from the mouth
• Fever
• Unexpected bleeding
• Sudden difficulty breathing or swallowing
• A marked change in the colour of the reconstructed tissue

In these situations you need to contact the surgical team without waiting.