Cancers of the head and neck start in the mouth, throat, voice box, nose and sinuses, salivary glands, thyroid, or in the skin and lymph nodes of the neck. Surgery is often the central part of their treatment, and it is one of the three main areas of Prof. Dr. Günter Hafız’s practice.
What it is
Head and neck cancer surgery removes a tumour together with a margin of healthy tissue around it and, when needed, the lymph nodes of the neck to which it may have spread. The region is small and full of the structures used for breathing, speaking, swallowing and facial expression, so planning is as important as the operation itself. Depending on the site and stage of the tumour (how far it has grown and spread), surgery can be the only treatment needed, or it can be combined with radiotherapy or chemotherapy before or afterwards.
Who it is for
Adults with a cancer of the mouth, tongue, throat, voice box, salivary glands, thyroid or neck, whether newly diagnosed, returned after earlier treatment, or suspected because of a lump or a lesion that has not healed.
Symptoms and diagnosis
Common warning signs are a sore or ulcer in the mouth that does not heal within a few weeks, a lump in the neck, persistent hoarseness, difficulty or pain on swallowing, one-sided ear pain without an ear infection, or blood in the saliva. Diagnosis rests on examination of the mouth and throat, often with a thin flexible endoscope; on imaging such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI) or PET; and on a biopsy, a small tissue sample examined under the microscope. Together these establish the type of tumour and its stage, which guide the treatment plan.
How the operation is done
The operation is performed under general anaesthesia. The approach depends on where the tumour is. Some tumours of the throat and voice box can be removed through the mouth with a laser and a microscope, leaving no external incision; others require an incision in the neck. Lymph nodes are removed through a neck dissection when there is a risk of spread. When a large area must be removed, tissue from elsewhere in the body can be transferred to rebuild the defect in the same operation (microvascular reconstruction), so that swallowing, speech and appearance are restored as far as possible. The removed tissue is examined by a pathologist, and the final report completes the picture of what further treatment, if any, is needed.
Recovery
The first days are spent in hospital, where breathing, swallowing and the wound are watched closely. Depending on the operation, a temporary feeding tube or a temporary breathing opening in the neck may be needed while healing progresses. Swallowing and speech therapy often start early. How long eating and daily life take to return depends on the operation: weeks for some, longer for others. Follow-up visits continue at regular intervals for years, because finding any recurrence early matters.
How Prof. Hafız works
Prof. Hafız has been a specialist in otorhinolaryngology (ear, nose and throat diseases) since 1994 and a professor of otorhinolaryngology since 2006, with head and neck cancer surgery, transoral laser surgery, airway surgery and microvascular reconstruction among his focus areas. He is a founding member of the Head and Neck Cancer Society and a member of the European Head and Neck Society and the International Federation of Head and Neck Oncologic Societies. He aims to explain each diagnosis and treatment plan so that you and your family feel informed and supported.