Head and Neck Surgery

We live by communication, which relies on hearing, speech and facial expression. Diseases of the head & neck can severely compromise a person’s ability to communicate, not only as a result of the disease process itself, but also as a result of the radical treatment, which may be necessary to cure the disease.

Quality of life for all of us is greatly enhanced by our use of the senses. Hearing, sight, smell and taste are all at risk from disease within the head and neck. In addition facial disfigurement in conjunction with communication problems can result in social isolation.

Conditions affecting the head and neck may be benign or malignant. They may affect the salivary glands, the thyroid gland, in the skin of the head and neck as well as the mouth, the gullet, the larynx (voice box), the sinuses, the nose and the ears.

One of the more common head and neck cancers is cancer of the larynx. Small tumours can be treated successfully with cure rates in excess of 90% by limited surgery or radiotherapy. Larger tumours invariably require radical surgery with removal of the entire larynx. This removes the patient’s ability to speak and so patients need to learn to talk again using a variety of techniques. The most common technique uses an implant between the gullet and the airway. This acts as a valve allowing the diversion of air from the airway into the mouth base for speech.

Cure rates of head and neck cancer are very dependent in the precise site of the tumour, its size and extent of any spread to surrounding structures. Patients with early, small cancers, can expect cure rates of greater than 90%, however many patients present with very advanced disease and so the overall cure rates are approximately 50%.

This emphasises the need for increased awareness in both the general population and the medical profession of the early symptoms of head and neck cancer. Patients need rapid access to specialist treatment by hospital clinicians who are trained in all aspects of the management of head and neck cancer. These rare cancers are best treated in dedicated centres by multidisciplinary teams.

Quality of life is undoubtedly affected by these tumours as well as the treatment used to eradicate them. Current research is being focused on quality of life issues to quantify the effect of current treatments with the hope that this will allow treatment protocols to be tailored much more closely to the needs of individual patients.