Head and neck surgery

Surgery is often the first treatment used for these cancers. Several types of operations can be done to treat oral cavity and oropharyngeal cancers, depending on where the cancer is located and its stage. It's most commonly used for small, early-stage cancers that haven't spread. After the cancer is removed, reconstructive surgery might be done to help restore the appearance and function of the areas affected by the cancer or cancer treatment.⁹

Nasal cavity cancers are often removed in a procedure called wide local excision. This means removing the tumor plus an edge of normal tissue around it. The goal is to remove enough tissue so that no cancer cells remain. If the tumor is in the middle dividing wall of the nasal cavity (the nasal septum), sometimes the entire septum or a large portion of it will be taken out.¹⁰

For most nasal cavity or paranasal sinus cancers, surgery to remove the cancer (and some of the surrounding bone or other nearby tissues) is a key part of treatment. Often, surgery is used with other treatments, like radiation therapy and/or chemotherapy to get the best results.¹¹

In most cases, some or all of the surrounding salivary gland will be removed. Nearby soft tissue may be taken out too. The goal is to have no cancer cells on the outside edges (margin) of the removed surgical tissue which contains the cancer. If the cancer is high grade (more likely to grow and spread quickly) or if it has already spread to lymph nodes, lymph nodes might be removed in an operation called a neck dissection.¹²

Surgeons use free flap surgery to reconstruct areas after head and neck cancer surgery by transplanting tissue from another part of the body. Based on the condition and circumstances, they may use different types of free flap surgery, such as those involving tissue from the forearm, thigh, or fibula. Blood vessels are microsurgically reconnected to ensure proper blood flow to the transplanted tissue.

Transoral robotic surgery (TORS) is a minimally invasive procedure that removes tumors from the back of the throat without the need for a mandibulotomy, which requires cutting through the jaw. Using the da Vinci® SP System, surgeons navigate the robotic system through the mouth to remove the tumor, avoiding external incisions.

Also known as a laryngectomy, larynx surgery is a surgical procedure to remove part or all of the larynx, the area of the throat that contains your vocal cords. It’s a treatment for laryngeal cancer or damage to the larynx from injury or other health complications.¹³

Surgery of the pharynx, also known as a pharyngectomy, is the surgical removal of the pharynx, a cone-shaped cavity that connects the esophagus to the nose and mouth. The surgery is used mainly to treat cancer of the hypopharynx and conditions like pharyngitis.

There are various forms of the procedure. Some remove a portion of the pharynx (partial pharyngectomy) while others remove it completely (total pharyngectomy).¹⁴

Surgery of the trachea, or a tracheostomy (also called a tracheotomy) is a procedure where a hole is made at the front of the neck. A tube is inserted through the opening and into the windpipe (trachea) to help you breathe.¹⁵

Esophagectomy is a surgical procedure to remove some or all of the tube connecting the mouth to the stomach, called the esophagus. The esophagus is then reconstructed using part of another organ, usually the stomach.

Esophagectomy is a common treatment for advanced esophageal cancer. It's sometimes used for a condition known as Barrett esophagus if precancerous cells are present.

An esophagectomy also may be recommended for noncancerous conditions when attempts to save the esophagus have failed.¹⁶

The main objective of neck cancer surgery is to remove the cancerous tumor and some of the healthy tissue around it to ensure the removal of all cancerous tissue. The surgery may also be used to remove lymph nodes in the neck if there is a risk that the cancer has spread.

Depending on the location and stage of the tumor, surgery can vary from minimally invasive procedures to more extensive operations that may require reconstruction of the affected area.¹⁷

Oropharyngectomy is the removal of part of the oropharynx. This is usually done for cancer of the oropharynx. The oropharynx is a difficult area to see and operate on because the teeth, jaw, and tongue are in the way. Sometimes tumors are removed through the mouth by holding the mouth open, this is called trans oral surgery.¹⁸

Transoral robotic surgery (TORS) radical tonsillectomy is an emerging minimally invasive surgical procedure for the treatment of cancer of the tonsil.¹⁹

A base of tongue resection, or a glossectomy, refers to the surgical removal of your tongue. Some people only need a portion of their tongue removed (partial glossectomy). Others may need half of their tongue removed (hemiglossectomy). Sometimes, it’s necessary to remove the entire tongue (total glossectomy).²⁰

Thyroid surgery treats conditions like goiters, hyperthyroidism, thyroid nodules, or thyroid cancer. Surgeons commonly perform hemithyroidectomy (partial removal), total thyroidectomy (full removal), and neck dissection (removal of lymph nodes). The type of surgery depends on the condition’s severity, cause, and individual needs.

Parathyroid surgery treats hyperparathyroidism, where overactive glands raise calcium levels, causing issues like weak bones and kidney stones. Surgeons may recommend targeted parathyroidectomy (minimally invasive), four-gland exploration (removing abnormal glands), partial parathyroidectomy (removing 3 or 3½ glands), or total parathyroidectomy (removing all glands, sometimes placing tissue in the arm).