What is Head and Neck Oncologic Surgery
Oncologic surgery for many types of cancer located in the head and neck region can be cured, especially when detected early. Although the main goal of treatment is to eliminate the disease, preserving the function of nerves, organs, and tissues in the region is also very important.
When planning treatment, the doctor evaluates the location of the tumor and how the chosen approach may affect the patient’s quality of life, including aspects such as speech (voice), eating, breathing, and even aesthetic outcomes.
Surgery is one of the main treatment options for head and neck cancer. It can be done alone or in combination with radiation therapy, chemotherapy, and targeted therapies. Before deciding on surgery, the doctor evaluates factors such as the type and stage of the tumor, possible adverse effects, and the patient’s overall health.
Types of surgery for head and neck cancer
There are several types of surgery for the treatment of head and neck cancer. Understand the main ones and for which cases head and neck oncological surgery is indicated:
- Laser surgery: can be used to treat an early-stage tumor, especially if it is located in the larynx;
- Excision: a technique that removes the tumor and part of the healthy tissue around it (the safety margin);
- Lymph node dissection or neck dissection: if there is suspicion that the cancer has spread, the doctor may remove the lymph nodes in the neck. This procedure can be done together with the excision;
- Video-assisted surgery: a minimally invasive procedure, using a video system and delicate, thin forceps;
- Flexible robotic surgery: a minimally invasive treatment adopted in selected cases, where the surgeon needs to access regions of the mouth and throat that are difficult to reach. It is done with the help of a flexible scope (a very thin tube);
- Partial laryngectomy: used in the treatment of small laryngeal tumors, where only the affected portion is removed, leaving the rest of the larynx intact;
- Total laryngectomy: adopted in more extensive laryngeal cancers, where total removal of the voice box is necessary. Tracheostomy is then performed, a process in which the trachea is surgically removed through an incision made in the neck to facilitate breathing. Patients undergoing this procedure have impaired speech, but on the positive side, liquids and solid foods can still be ingested normally;
- Myocutaneous flaps: the throat is reconstructed using flaps of muscle and skin located in a nearby area; and
- Reconstructive plastic surgery: if the surgery to remove the tumor requires the removal of a large part of the tissue, such as in the jaw, pharynx, or tongue, the doctor may include reconstructive surgery in the treatment. In addition to reconstructing the affected area, this type of surgery works on the aesthetic aspect, leaving the appearance as natural as possible.
Other professionals may be involved in head and neck cancer surgeries. This includes the prosthodontist (a dentist specialized in dental prostheses, to develop a prosthesis that helps the patient swallow food and speak) and the speech therapist (a specialist who can use techniques and equipment to help the patient rehabilitate speech and feeding ability).
Possible adverse effects of head and neck cancer surgery
Possible adverse effects of head and neck cancer surgery in oncology depend on the technique used and the location of the surgery. The main ones are:
- Temporary or permanent loss of voice;
- Injuries to the vocal cords, affecting the way a person speaks;
- Hearing loss;
- Difficulty chewing and/or swallowing food;
- Lymphedema (accumulation of lymphatic fluid in adipose tissue);
- Decreased thyroid gland function (may occur after total laryngectomy, corrected with thyroid hormone use); and
- Swelling of the mouth and throat (making breathing difficult; if it occurs, temporary tracheostomy may be performed).
