Reconstructive

Head and Neck Cancer

Head and Neck surgery generally refers to the treatment of major head and neck cancers.  These cancers can arise from the skin (scalp, nose, lip, ear etc), the salivary glands (parotid gland, submandibular gland), inside the oral cavity (tongue, palate, tonsil etc), or any other structure in the head and neck region.  Often these major cancers have spread to the lymph nodes in the neck.  The surgical treatment of these cancers is often quite extensive and destructive, requiring major reconstruction.

The types of operation are many and varied, depending on where the cancer is situated, how much tissue needs to be removed, whether lymph nodes need to be removed, and what reconstruction may be required.  Common operations include:

  • Parotidectomy: removal of the parotid salivary gland
  • Pinnectomy: removal of the ear
  • Rhinectomy: removal of the nose
  • Wedge resection of the lip or eyelid: partial removal of these structures
  • Hemiglossectomy: removal of part of the tongue
  • Neck dissection: removal of some or all of the lymph nodes in the neck.

Reconstruction may involve the use of grafts (skin, cartilage, bone), local tissue flaps, muscles flaps or even microsurgical tissue flaps ("free flaps").

After the Operation

Recovery very much depends on the type of operation.  Some of these operations take many hours to perform, and the patient may well be expected to be in hospital for up to a week.  There can be issues with eating, drinking, speech and mobility after some of these procedures.

Head and Neck surgery is usually performed in an effort to eradicate and cure cancer.  Often additional treatment with radiotherapy is required, provided for in the public health system.  Some types of cancer have very high 'cure rates' with this surgery.  Other types have lower rates of success.  The surgery itself can have long term side effects on the patient, both in appearance and function.

All surgery carries risk of side effects and poor outcomes.  Head and Neck surgery in particular has the potential for a number of important complications.  This is due to the nature of the head and neck itself, where anatomically there are major and functionally important nerves, major large blood vessels, and other structures of huge importance, all tightly packed into a fairly small area of the body.

These potential complications are always discussed in depth at the time of consultation, to ensure the patient is fully informed before undergoing this type of treatment.

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