Jessica (bat_hawk) wrote in little_details,

Rehabilitation after total glossectomy (complete removal of the tongue) and accompanying PTSD

Setting: modern day
Search Terms: "speech after loss of tongue" "rehabilitation after cutting out tongue" "rehabilitation after total glossectomy" "speech without tongue" "swallowing without tongue"

I'm in the idea phase of a story involving a major character whose tongue has been cut out. I managed to stumble across the proper medical term, so I now know that it is possible to pretty much completely regain speech, and to swallow at least functionally without a tongue. My question is how exactly that rehabilitation would take place. Beyond someone mentioning that her therapists had started her with swallowing water (that is apparently the hardest thing to swallow because it is very thin?), I haven't found anything that goes into detail. I don't need intimate knowledge or anything, just a sort of general understanding of how the mechanism would even happen. For example, would one have to tilt their head back and shake it to get anything solid back into the throat to swallow it, or is there some more elegant solution? I can't really find anything with that.

Beyond the purely physical, I am wondering what effect his psychological condition would have on his ability to speak. It seems from what I've been reading that a person's belief in whether or not they can speak without a tongue is largely the determining factor in whether they will in fact be able to speak or not. There were some very interesting accounts from Persia, where there apparently is/was a belief that cutting off the tip of the tongue will prevent people from speaking again, but cutting off the whole thing will leave speech intact.

Anyways, my character would have had his tongue removed forcibly while he was a prisoner of war, which I imagine would leave him with some pretty intense PTSD. Most of the modern stories I've read have been about people who voluntarily underwent the procedure to get rid of cancer, so they had plenty of time beforehand to reconcile themselves to what was going to happen, and had already decided that it was the best option. For my poor guy, this was a calculated act of violence intended to break him and his fellow prisoners. I'd imagine the mental conditions afterwards would be vastly different, especially as he remained in captivity for a few months after having his tongue removed. If personality matters at all, I would be happy to elaborate on his.

As a final consideration, modern patients getting total glossectomies will have tissue grafted from elsewhere during the surgery to fashion a sort of placeholder tongue. Obviously, that is out of the question for my character, and I wonder how much of a difference that would make to his recovery.

Thanks in advance for any enlightenment y'all can provide.
Tags: ~medicine: injuries (misc), ~mute/unable to talk, ~psychology & psychiatry: ptsd

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