Head And Neck Surgeries
What is Mouth and Throat Region Cancers?
Oral cancers most often occur over the age of 40 and are twice as likely to occur in men than in women. The most common areas where oral cancers occur are; tongue, floor of the mouth, soft palate parts close to the tongue root, lips and gums. If oral cancer is not diagnosed and treated at an early stage, it can spread and cause constant pain, loss of function, facial and mouth deformities, and even death.
What are the Causes of Oral Cancers and Tongue Cancer?
Although the exact cause of oral cancers is not known, it has been found that cigarettes, tobacco products, alcohol, HPV virus and carcinogens in some foods increase the risk of oral cancer. Genetic susceptibility is among the important risk factors for oral and tongue cancers.
What Are the Symptoms of Oral Cancers?
It appears as white or red areas on the tongue, in or around the mouth. If the underlying cause is a lesion due to an HPV virus, it is mostly seen as condyloma and wart. Recurrent bleeding in the mouth or throat, hoarseness in the voice or the feeling of an object that cannot be swallowed in the throat, difficulty in chewing and swallowing, difficulty in tongue and jaw movements, loss of sensation in the tongue or other parts of the mouth, numbness, mass – lesion sensation in the mouth can be symptoms of mouth and tongue cancer.
Does HPV Virus Create Risk for Oral Cancer and Tongue Cancer?
HPV virus, which is transmitted by oral sex, has been shown as one of the important causes for very rare oral cancer and tongue cancer in recent years. This virus, which also causes throat cancer, is seen with increasing frequency in our country. It should not be forgotten that women who have warts in the genital area and who have a history of oral sex also have condyloma, warts and similar lesions in their mouth areas at the same time, necessitating a referral to a physician.
What is Laryngeal Cancer?
Laryngeal cancers are one of the most common types of cancer in Otorhinolaryngology.
The tumor is usually confined to the larynx for a long time before spreading to the surrounding organs and neck. With early diagnosis, the disease has a chance to be completely cured.
However, in patients presenting in the later stages and as a result of their treatment, permanent loss of function may occur, which reduces the quality of life of the patient and causes great difficulties in his social life.
Complete removal of the larynx, which causes the patient to completely lose their vocal cords, unable to speak, and completely break their communication with the environment, and creating a permanent hole in the patient’s neck so that they can breathe is the most extreme point of the problems that may arise.
Although it is not known exactly how laryngeal cancers occur like other types of cancer, it has been revealed that it is directly related to smoking. Alcohol use along with smoking increases this risk.
Laryngeal cancer is most common in men aged 50-60 years. However, it should not be ignored that it is starting to appear at younger ages and in women.
Unfortunately, as with many other types of cancer, laryngeal cancer does not have any symptoms specific to the disease. Symptoms of laryngeal cancer are mostly related to its location and size within the organ. If the tumor is located on the vocal cords or has progressed to this area, hoarseness and changes in voice quality are usually the first symptoms to occur. For this reason, prolonged hoarseness should not be neglected and an ENT specialist should be consulted. Other symptoms of throat cancer; It can also be in the form of a feeling of stuck in the throat, pain in the throat, pain reflected in the ears. Note that these symptoms can also be caused by any throat condition (eg pharyngitis). Therefore, consult your doctor for any prolonged complaints. Large tumors; They give symptoms such as shortness of breath, difficulty in swallowing, pain during swallowing, bloody sputum. The patient may experience general weakness and weight loss. However, by the time these symptoms appear, the disease is quite advanced. If the cancer has spread to the neck, swelling occurs on the side of the neck.
Laryngeal cancers usually stay in the organ for a long time, and they spread in the larynx. They then spread to surrounding organs and lymph nodes in the neck. It is rare for cancer to spread to distant organs such as lung, bone, liver and is usually seen in advanced tumors. With this form, it has a relatively milder course than many types of cancer that appear elsewhere in the body.
There is a treatment option for all patients with laryngeal cancer. The choice of treatment type is also made according to where the cancer is in the larynx, its stage, the person’s age and general health.
Basically, three types of treatment methods are applied:
* Surgery (surgical removal of cancerous tissue)
* Radiation therapy (use of radiation beams to kill cancer cells)
* Chemotherapy (treatment with drugs that kill cancer cells)
Surgery: It is the most effective treatment method in many laryngeal cancers and is frequently used in the treatment of laryngeal cancer. One of the following surgeries may be used to remove cancer and portions of the larynx:
Cordectomy: removal of a vocal cord
Partial laryngectomy: Removal of part of the larynx
Total Total laryngectomy: Removal of the entire larynx.
In all of these surgeries, a hole can be opened in the front of the neck leading to the trachea, and breathing is provided from here. Since the entire larynx is removed in total laryngectomy, this hole is permanent. In other surgeries, the hole is closed after the surgical site heals. If the cancer cells have spread to the lymph nodes in the neck or are likely to spread, it may be necessary to remove the lymph nodes in the neck during the surgery (neck dissection).
Laser surgery: Removal of cancer tissue with laser beam in some early diagnosed laryngeal cancers
Radiation Therapy: In (Radiotherapy), cancer cells are killed and tumors are reduced by using high-energy radiation beams. Radiation rays are usually given to the neck with an external device in laryngeal cancers. The application is made by giving a certain dose of radiation every day, and this treatment usually lasts for 6 weeks in laryngeal cancers. Some drugs may also need to be given during radiotherapy to increase the effect of radiation on cancer cells.
Chemotherapy uses drugs to kill cancer cells. Some of the drugs used in chemotherapy are in the form of oral pills; however, they are drugs that need to be administered in most hospitals and are given in the form of injections. Type of treatment; The region where the tumor is located in the larynx varies according to their spread and size. The patient’s age, general condition, lung functions and patient preferences are other factors that guide the treatment. In our country, the treatment of laryngeal cancer is mainly performed by surgical methods. Radiotherapy (radiation therapy); It is applied in 4-6 week courses for small tumors on the vocal cords or as an adjunct method that completes the surgical treatment. Large sized diffuse tumors have a very low chance of control with radiotherapy alone. Chemotherapy application (drug therapy) can only be applied in large-sized diffuse tumors, to reduce the tumor volume and to prepare for classical treatment methods. Early diagnosis is of great importance in the treatment of the disease. In small-sized cancers, if the general condition of the patient is suitable, only the tumor part can be removed with safe limits by partial surgery (conservative surgery), without the need to remove the entire larynx, and thus the vocal cords and other parts of the larynx can be preserved. In most of this group of surgeries, there is no need to make a permanent hole in the throat. Today, there are many surgical methods that allow the treatment of the larynx without the need for complete removal. These surgeries are performed in our country in centers specialized in laryngeal cancer. However, in large and widespread tumors, complete removal of the larynx may be necessary. In this case, the vocal cords are sacrificed to cure the cancer. The trachea is fixed to the neck skin so that the patient can breathe. In this case, it is obligatory to create a permanent hole in the patient. However, there are many methods for patients whose vocal cords have been removed to be able to speak intelligibly again. These include training the patient to use the pharyngeal voice and speech prostheses. If the tumor has spread to the lymph nodes in the neck in proportion to its location and dimensions, or if the patient is at risk, the treatment of the neck is also included in the surgical plan.
With the treatment modalities applied today, it is possible to fully cure the patients and to have a long life. However, early diagnosis of the disease is very important for this. In general terms, with the complete treatment of a small tumor on the vocal cords, 5-year survival is possible in 90-95% of the cases. In an advanced tumor, these rates decrease to 35-50%. These findings highlight the importance of early treatment of cancer.
What is Salivary Gland Cancer?
The salivary glands are located around the mouth and in the throat. The main glands are the parotid (just below the auricle), submandibular (under the jawbone) and sublingual (anterior under the tongue) glands.
All these glands secrete saliva into the mouth through a channel at the level of the parotid upper teeth, the channels under the submandibular tongue, and the small channels in the mouth tab in the sublingual glands.
In addition to the main large glands, there are hundreds of smaller glands. These are located inside the lip, on the inside of the cheek. The secretion produced by the salivary glands keeps the mouth moist, initiates digestion and protects the teeth against decay.
Salivary Gland Cancer and Tumors with Questions
Yes, “mixed tumors”, usually involving the salivary glands under the ear.
No. Tumors of the salivary glands under the ear are usually benign. But the gland can be transmitted many times with the formation of a cancerous disease.
Yes, even if these tumors are benign, they tend to recur in one out of every five cases.
Benign tumors develop slowly and often have a capsule around them. Most of them can be played under the skin. Malignant tumors that develop in the salivary glands grow quickly and become tightly adhered to the skin and surrounding tissues. After the tumor is removed, microscopic examination determines whether the tumor is malignant or benign.
No. However, surgeries to remove the salivary glands under the ear are both difficult and long-term. It is necessary to be very careful in these surgeries in order to avoid any damage to the stamen stems of the facial nerves passing through the salivary glands under the ear. An injury to this nerve causes partial paralysis of the face.
General anesthesia is used for important surgeries, and local anesthesia is used for minor surgeries.
In front of the ear and at the level of the chin, extending to the neck.
No. After the wounds have completely healed within a few months, only the wispy white streak remains.
No. In some cases, it may be necessary to touch this nerve and in some cases to cut a part of it, while an overgrown morbid formation is removed from the salivary glands under the ear. However, this happens in very rare cases; Considering that the most important job is to remove the dangerous tumor, it has to be endured as a result.
What happens when the facial nerve is damaged while removing an under-ear salivary gland tumor?
The face is partially paralyzed and disfigured; one side of the mouth remains low and sprained. In some rare cases, a part of the nerve to the eyelid may be damaged, causing the patient to not be able to close this eye completely.
That’s roughly it. However, this deformity may lessen over time.
Their diameter is as thin as sewing thread. Therefore, it is a very difficult process to find their ends and attach them to each other. Recently, in such cases, it has been achieved to bring the deformed faces closer to normal by performing dexterous muscle and nerve transplantations. In order to do this, a very skilled plastic operator should be consulted.
Yeah. After the surgery, salivary discharge may continue on the skin for days, and in some cases for weeks. However, such discharges stop on their own after the wounds are completely healed.
After the surgery, liquid foods are taken for a few days, and then normal food can be eaten.
The vast majority of patients can leave the hospital one week after surgery.
Yeah. Most of the surgeries will be successful if a larger amount of tissue is removed from the under-ear salivary glands.
With the complete surgical removal of the gland.
Yeah; however, if this procedure is not performed on a rapidly developing cancer in these structures, the success rate is almost one hundred percent. Such malignant abscesses are rarely encountered.
HEAD AND NECK CANCERS
Knowing the Warning Signs About Cancers?
Did you know that 55,000 Americans are diagnosed with cancer in the head and neck region in a year, 13,000 of them die, and these can be prevented?
Tobacco is the most preventable cause of these deaths. More than 200,000 people in the United States die each year from smoking-related diseases. The good news is that this number is falling with the increase in the number of Americans who quit smoking. The bad news is that some smokers are turning to smokeless tobacco, chewable tobacco, which is thought to be a safe alternative but not true. This only carries the risk of cancer in the person from the lungs to the lips. While the incidence of lung cancer is decreasing, the number of head and neck cancers is increasing.
Head and neck cancers can be treated if caught early. Early symptoms of head and neck cancer enable early diagnosis. You should be aware of possible warning signs and alert your doctor as soon as possible.
Remember that successful treatment of head and neck cancers depends on early detection. Knowing some warning signs can save your life in head and neck cancer.
What Should We Observe?
A lump in the neck: Head and neck cancers usually spread to the lymph nodes in the neck before spreading anywhere else in the body. Swelling on the neck that does not go away for more than 2 weeks should be seen by a doctor as soon as possible. Of course, not all bumps mean cancer. However, swelling or swelling can be the first sign of mouth, larynx, goiter cancer, some lymph cancers and blood cancer. Such swellings are usually painless and tend to get larger.
Voice change: Many laryngeal cancers cause voice changes. Hoarseness or voice changes lasting more than 2 weeks should alert you to see your doctor. An otolaryngologist and head and neck specialist; can examine your vocal cords with easy and painless methods. Although cancer is not the cause of many voice changes, you should not leave it to chance. If your hoarseness lasts longer than 2 weeks, you should make sure that you do not have laryngeal cancer and go to your doctor.
Lip growth: Most tongue and lip cancers cause persistent sores and swelling. Wounds and swellings are painless unless they become inflamed. Although bleeding may occur, it is often not seen until the advanced stages of the disease. If the wound or swelling accompanies a mass in the neck, this should be taken very seriously. Your dentist or doctor may evaluate whether a biopsy (tissue sampling test) is needed and refer you to a head and neck surgeon for this procedure.
Bleeding: This is often due to a cause other than cancer. However, mouth, nose, throat and lung tumors can cause bleeding. You should see a doctor if bleeding occurs in saliva or sputum for more than a few days.
Swallowing problems: Cancers of the throat and esophagus make it difficult to swallow solid foods and sometimes liquids. At a certain point, the food feels stinging and either goes into the stomach or comes back through the mouth. In this case, you should consult a doctor. The cause is usually revealed by direct examination of the esophagus through an X-ray barium swallow film or a swallowed tube.
Changes in the skin: Skin cancer, which is very common in the head and neck, responds well to early treatment. Although it is most commonly seen on areas where the skin is exposed to the sun, such as the forehead, face, and ears, it can occur anywhere on the skin. Skin cancer often starts as a small pale sore, grows slowly, with a dimple-shaped pit or even an ulcer in the middle. While some of this area heals, a larger portion remains ulcerated. Color changes are seen in some skin cancers.
Other types of cancer seen in the head and neck include; squamous cell carcinoma and malignant melanoma. Some of the squamous cell cancers are seen in the lower lip and ear. It is similar to skin cancer and usually does not become more dangerous if detected early and treated appropriately. If there is a non-healing wound on the lip, face or ear, seek medical advice immediately. Malignant melanoma classically causes a dark blue-black color change in the skin. However, the size, color change and the beginning of bleeding in any mole are also a problem. In the presence of a blue-black spot on the face and neck, which varies in size and shape, a dermatologist or another doctor should be consulted as soon as possible.
Ongoing earaches: Pain in and around the ear while swallowing may be due to a growing tumor or infection in the throat. Such a complaint; It is even more noticeable if it is accompanied by difficulty in swallowing, hoarseness or a swelling in the neck. These findings should be evaluated by an Ear Nose and Throat Specialist as soon as possible.
Identification of High Risk in Head and Neck Cancers?
Up to 30% of head and neck cancers are closely related to long-term exposure to specific factors such as smoking and alcohol. Oral and throat cancer is almost never encountered in adults who do not smoke or drink. Long-term exposure to sunlight is associated with lip cancer and is the biggest cause of skin cancer.
What Should You Do?
All the signs and symptoms described may also be present in non-cancerous conditions. In fact, most of the time, these complaints can be seen in some other conditions other than cancer. But you can’t tell this without a good examination. Therefore, in the presence of these complaints, go to your doctor and be sure.
Remember!
There is a great relationship between the early diagnosis of head and neck cancers and the success of treatment. We believe that treatment rates will increase as the medical recommendations here reach a large number of people.
