Surgery for head and neck tumors
Surgery is one of the main treatments for head and neck cancers. It is provided alone or in combination with radiotherapy or chemotherapy.
Surgery usually involves removing the tumor and the lymph nodes in the neck, either together or alone (neck dissection). Both surgeries can be done during a single operation.
Neck dissection is used to remove and analyze lymph nodes that may be affected by the cancer. If the initial examination does not reveal any suspect nodes, neck dissection allows all the lymph nodes in the neck to be analyzed under the microscope, thereby reducing the risk of cystic metastasis developing at a later stage.
Removal of the tumor
Depending on the location and extent of your tumor, it may be possible to remove it through your mouth (transoral surgery, which may be laser microsurgery or transoral robotic surgery). However, the surgeon may need to make a cut in your neck (cervical incision) to reach the tumor. Depending on the situation, the excision area may be left open to heal by secondary intention or the excised tissue may be reconstructed using a flap of tissue removed locally (e.g., from the cheek or neck). Reconstruction is carried out during the same operation.
In some situations, the tissue needed for the graft is taken from another part of the body (e.g., skin from the forearm or thigh, or bone from the fibula). Arteries and veins in the graft tissue are connected to those in the neck (secondary anastomosis) in order to make the graft viable and promote healing.
Operations on the neck, throat and mouth often require a tracheostomy and for food to be given via a nasogastric tube during postoperative healing and speech reeducation.
Technological progress and advances in operating techniques have resulted in these surgeries becoming less invasive and reduced their negative effects. The surgery team uses mini-invasive techniques (often known as keyhole surgery) such as robot-assisted surgery and endonasal endoscopy, which allows small tumors from the base of the skull or the sinuses to be removed through the nose. These techniques are just as effective as traditional surgery but they reduce postoperative scarring.