Cancers begin when normal cells change and grow out of control, forming a mass that we call a tumour. A benign tumour is non-cancerous and is restricted to its location. Whereas, a malignant tumour can grow and spread to other parts of the body. ‘’Head and neck cancer’’ is a collective term for malignant tumours arising either in or around the mouth, throat, larynx, nose, and sinuses. The most common of these cancers is squamous cell carcinoma.
Head and neck cancer surgery is a treatment plan for cancers occurring in the head and neck. The structure(s) that the cancer affects, as well as the cancer stage, and spread determine the type of surgical procedure your surgeon will adopt.
Dr Stephen Kleid is a renowned Ear, Nose, and Throat (ENT) surgeon in Melbourne, Australia. He has conducted several successful head and neck cancer surgeries using some of the surgical procedures discussed in this article.
There are five major types of cancers that affect the head and neck region. We name these according to the part of the body where they develop. Determining the type of cancer you have is crucial in choosing the type of treatment for head and neck cancer.
The larynx, also known as the ‘’voice box’’, is a tube-shaped organ in the neck that contains our vocal cords. It is vital for not only talking and breathing but also swallowing. The hypopharynx surrounds the larynx at the lower part of the throat.
Cancer can arise from any part of the larynx or hypopharynx. Furthermore, around 90% of the laryngeal and hypopharyngeal cancers develop from the layer of flat (squamous) cells lining these organs.
The nasal cavity is the space behind the nostrils that serves as a conduit for air that passes to the throat. Furthermore, the paranasal sinuses are air-containing pockets that surround the nasal cavity. Cancers that develop from these structures are malignant and of different types, depending on the cells they affect.
The nasopharynx is the upper part of the pharynx behind the nasal cavity and above the soft palate (posterior part of the roof of the mouth). It is made up of different types of cells from which cancers can arise. The type of cell affected determines both the severity of cancer and the type of treatment patients will require.
The oral cavity includes both the mouth and tongue, while the oropharynx is directly behind. The oropharynx consists of the soft palate, tonsils, and base of the tongue. Furthermore, approximately 94% of the cancers here arise from flat cells lining the oral cavity and oropharynx.
It is essential to know the part from which cancer developed between the two because this can change the type of surgery to be done.
Three paired salivary glands produce saliva, which is the fluid your body releases into the mouth to keep it moist, it also helps break down food substances. These are the parotid glands, submandibular glands, and sublingual glands. Tumours from the salivary glands can be either benign or malignant. The cells involved determine the type of tumour.
The goal of head and neck cancer surgery is the removal of the tumour as well as the surrounding tissue it affects. Dr Kleid has proven himself over time, this is evident by the many successful surgeries he has undertaken.
He works with a multidisciplinary team that can comprise of anaesthetists, specialist nurses, maxillofacial surgeons, reconstructive surgeons, speech pathologists, and many others to ensure you receive the highest quality of care as well as, patient satisfaction.
Imaging tests like Magnetic Resonance Imaging, CT scans, and X-rays can help Dr Kleid know the exact location of the tumour.
The following are procedures involved in the treatment of head and neck cancer:
- Wide local excision
- Glossectomy, Maxillectomy, Mandibulectomy
A laryngectomy is an invasive technique that doctors use in the treatment of laryngeal cancers. Depending on your cancer’s location, size, type, and stage, Dr Kleid will choose the laryngectomy that suits your condition.
Partial laryngectomy is the removal of cancer while leaving behind as much of the larynx as possible. If the size of your cancer is small, a partial laryngectomy may be the way to go.
A prominent laryngeal cancer will often result in a total laryngectomy, this involves the complete removal of your larynx. After the removal, the surgeon will draw up your trachea to the level of the hole made through the skin in front of your neck for you to breathe.
Dr Kleid carries out a laryngectomy under general anaesthesia. In other words, you will be unconscious throughout the procedure and won’t feel any pain.
You may be a suitable candidate for a laryngectomy if you have been experiencing the following symptoms of laryngeal cancer:
- Hoarse sound while speaking
- Painful or difficulty swallowing
- Chronic cough
- Persistent earache or sore throat
- Difficulty breathing
If a partial laryngectomy is done early, it can not only stop cancer growth but can also preserve the vocal cords.
Wide local excision is a technique surgeons use to remove cancers in the nasal cavity. It involves the excision of the tumour and the immediate normal tissue surrounding it. Wide local excision ensures that we remove all cancer cells, leaving only healthy tissue behind.
If the tumour is in the nasal septum of the nasal cavity, the surgeon will either remove a large part or the whole of the septum. If it is in the lateral wall of the nasal cavity, Dr Kleid will cut through the skin on the side of the nose and fold it to the opposite side to access the tumour. Then he removes the part of the nasal cavity involved.
We will also place you under general anaesthesia during wide local excision.
Consult Dr Kleid for proper assessment of your condition if you have been experiencing the following symptoms:
- Persistently blocked nose
- Loss of sense of smell
- Nose bleeding
- Mucus draining from the nose
- Mucus draining into the throat.
- Numbness in the face
- Partial loss of vision
- Pain in one of the ears
These symptoms suggest nasal and sinus cancer. However, they are more likely to be a result of another non-malignant disease. We recommend a nasal endoscopy to diagnose nasal and sinus cancer. Nasal endoscopy involves the use of a lens and light to examine your nose.
Nasopharyngectomy is the surgical treatment for nasopharyngeal cancers – cancers behind your nasal chamber. It is rare to perform this procedure because it is difficult to gain access to tumours in the nasopharynx. We prefer this for the removal of small tumours that are yet to grow beyond the nasopharynx.
Dr Kleid can perform nasopharyngectomy with or without the aid of endoscopy. However, if the tumour in your nasopharynx is small, he will use an endoscopy.
A larger tumour requires open surgery that involves a direct incision.
For a nasopharyngectomy you will also go under general anaesthesia, rendering you unaware and pain-free during the entire procedure.
Although rarely done, we use nasopharyngectomy in the following conditions:
- Complete removal of a small nasopharyngeal tumour that has not grown beyond the nasopharynx
- Removal of a small tumour that recurs after radiation therapy
You should seek proper evaluation for nasopharyngeal cancer if you have been experiencing the following symptoms:
- Persistent headache
- Sore throat
- Nose bleeding
- Pain in the ear
- Poor hearing
- Difficulty breathing
Surgeons will perform a Parotidectomy to remove both benign and malignant tumours in the lobes of the parotid gland, (the location of which is just above your jawbone). There are two types of parotidectomy: superficial and total parotidectomy.
Dr Kleid will recommend a superficial parotidectomy if the tumour is found within the superficial lobe of the parotid gland. He will make a cut in front of your ear and down your neck to access the parotid gland.
In total parotidectomy, he will remove the entire gland. Dr Kleid recommends this when the tumour is confined in the deep lobe. Sometimes, he also removes lymph nodes together with the parotid gland to ensure no cancer cell remains.
A complication of parotidectomy is an injury to the facial nerve, which passes through the parotid gland. The damage can manifest as numbness on the face or an inability to move some facial muscles.
You may require a parotidectomy if you have been experiencing the following symptoms:
- Numbness in your face, mouth, jaw, and neck
- Long-lasting pain in your face, neck, jaw, or mouth
- Gum bleeding
- Painful swallowing
- Difficulty opening your mouth
Surgery is the standard treatment used for these cancers. Depending on the cancer site, Dr Kleid can do various surgical procedures to remove both oral cavity and oropharyngeal cancers. After these procedures, patients will need reconstructive surgery to restore both the normal function and appearance of the affected part.
Glossectomy involves either the partial or complete removal of the tongue. However, for small cancers, Dr Kleid only removes the part affected, this is a partial glossectomy. Unfortunately, larger cancers may require complete removal of the tongue.
Maxillectomy involves either the partial or complete removal of your maxilla or upper jaw. Dr Kleid performs this if your tumour is located on your hard palate (anterior half of the roof of the mouth).
After this procedure, a hole in the roof of your mouth is covered with a denture constructed to replace the oral cavity tissues.
Mandibulectomy involves either the partial or total removal of the lower jawbone. If the cancer is located in your lower jawbone, you will need X-rays to confirm the extent of tumour growth.
If the X-ray shows that the tumour has not grown into the jawbone, partial or marginal mandibulectomy is recommended. However, if the tumour has grown into the tissue, Dr Kleid will remove a large part of the jawbone in a segmental mandibulectomy procedure.
If you are concerned that you might be showing symptoms of some type of head and neck cancer, set an appointment with Dr Kleid. As one of Australia’s most experienced head and neck tumour surgeons, you will receive the best quality of care in the region.
What is surgery of the head and neck?
Surgical head and neck cancer treatment involves surgically treating a variety of head and neck problems, with tissue removal and reconstruction.
What is a head and neck surgeon called?
A surgeon who specialises in the surgical techniques for diseases that affect the head and neck is called an ear, nose, and throat (ENT) specialist or an Otorhinolaryngologist.
Is ENT the same as head and neck surgery?
ENT surgery is a subset of head and neck surgery because it focuses on the ear, nose, and throat. We also call this otolaryngology-head and neck surgery because specialists are trained in both medicine and surgery.
Do ENT doctors perform surgery?
ENT doctors, such as Dr Kleid, are trained to treat and perform highly complex surgery on the ear, nose, throat, and sinuses. ENT doctors also treat patients with cancers of the inner and outer ear.
Do ENT doctors treat mouth problems?
An ENT doctor can treat your mouth problems. However, an ENT doctor will refer you to an oral surgeon should you need surgery in advanced cancer cases. You may require a reconstructive surgeon to restore proper function and appearance.
Can a neck tumour be removed?
Dr Kleid can remove tumours through an incision in the skin of your neck. This incision also gives access to lymph nodes surrounding the affected piece of tissue to be removed.
How long does it take to recover from a neck dissection?
After a neck dissection, you may have swelling on the neck, but it usually resolves within 5 to 6 days post-surgery. You may also experience numbness in your ear and neck. Most people recover fully by eight months after surgery.
Why Choose Dr Kleid for Ear, Nose and Throat Surgery?
Dr Stephen Kleid
Ear Nose and Throat Surgeon (Otolaryngologist)
Masada Medical Centre
26 Balaclava Road,
East St Kilda, Victoria
Dr Stephen Kleid is an experienced Ear, Nose and Throat ENT Surgeon (Otolaryngologist) based in St Kilda.
Dr Kleid’s Procedures
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