Surgery is often the first-line treatment option for head and neck cancers. Some patients may be treated with surgery alone, while, for other patients, combining head and neck cancer surgery with radiation therapy and / or chemotherapy may be appropriate.
Specific surgical treatment may be required depending on the type of head and neck cancer. Some of them are as follows :
Vocal cord stripping : This approach may be used to take a biopsy sample, or to treat some stage of cancers confined to the vocal cords. Vocal cord stripping rarely impacts speech.
Cordectomy : In a cordectomy, part or all of the vocal cords are removed. This approach may be used to treat glottic cancer that is very small or located only on the surface tissues. Removing part of a vocal cord may lead to a hoarse voice. If both vocal cords are removed, speech is no longer possible.
Laryngectomy : This operation removes part or all of the larynx.
Partial laryngectomy : For small laryngeal cancers, only the portion of the voice box affected by the cancer may be removed, leaving the rest of the larynx intact. A partial laryngectomy may be used to remove the portion of the larynx above the vocal cords (supraglottic laryngectomy), or only one of the two vocal cords (hemilaryngectomy).
Total laryngectomy : For more extensive laryngeal cancers, the entire voice box is removed. Then, in a process known as a tracheostomy, the windpipe is surgically moved toward a hole in the neck for breathing. For patients who follow this treatment option, normal speech is no longer possible.
Myocutaneous flaps : The throat is reconstructed using muscle and skin from a nearby area that is rotated toward the throat.
Pharyngectomy : This operation removes part or all of the throat
Free flaps : Using “microvascular surgery,” in which small blood vessels are sewn together under a microscope, it may be possible to reconstruct the throat using tissues from other areas of the body, such as the intestines or arm muscle.
Lymph node removal : Cancer of the pharynx sometimes spreads to the lymph nodes in the neck. This operation is called a neck dissection, and is usually performed at the same time as surgery to remove an already existing tumor. The exact amount of tissue that needs to be removed depends on the stage of the cancer. With the most invasive procedure, some nerves and muscles that control neck and shoulder movement may be removed with the lymph nodes.
Tracheotomy/Tracheostomy : A tracheotomy is performed to create an alternate pathway for breathing by creating a hole, or stoma, in the trachea, or windpipe. After a total laryngectomy, the opening in the windpipe is connected to an opening in the front of the neck to provide a new pathway for breathing.