Surgical options
Surgery is often the first line of treatment for head and neck cancer. Some patients may be treated with surgery alone; for other patients, combining head and neck cancer surgery with radiation therapy and/or chemotherapy may be appropriate.
Your doctor may recommend a specific surgical treatment depending on the type and stage of the disease. Some of these surgical procedures include:
Cordectomy
In a cordectomy, part or all of your vocal cords are removed. This approach may be used to treat glottic cancer that is very small or located only on surface tissues. If you receive a cordectomy, you may experience changes in speech.
Free flaps
Using microvascular surgery, in which small blood vessels are sewn together under a microscope, it may be possible to reconstruct your throat using tissues from other areas of your body, such as your intestines or arm muscle.
Laryngectomy
During this operation, part or all of your larynx is removed. Your surgeon may perform a partial laryngectomy or total laryngectomy.
Partial laryngectomy: If you have a small laryngeal cancer, it may be possible to remove only the portion of your voice box affected by cancer, leaving the rest of your larynx intact. A partial laryngectomy may be used to remove the portion of your larynx above your vocal cords (supraglottic laryngectomy), or only one of the two vocal cords (hemilaryngectomy).
Total laryngectomy: For more extensive laryngeal cancers, a total laryngectomy may be the recommended treatment. With this procedure, the entire voice box is removed. Then, in a process known as a tracheostomy, your windpipe is surgically moved toward a hole in the neck for breathing. If you follow this treatment option, normal speech is no longer possible, but other forms of speech can be learned.
Myocutaneous flaps
During this operation, your throat is reconstructed using muscle and skin from a nearby area that is rotated toward your throat.
Pharyngectomy
This operation involves removing part or all of the throat.
Tracheotomy/Tracheostomy
A tracheotomy creates an alternate pathway for breathing by creating a hole, or stoma, in your trachea, or windpipe.
Vocal cord stripping
With this technique, a long surgical instrument is used to remove the outer layers of tissue on your vocal cords. This approach may be used for a biopsy, or to treat some stage 0 cancers confined to the vocal cords. Vocal cord stripping rarely impacts speech.
Surgical technology
Some of the surgical technologies and techniques available to head and neck cancer patients at City of Hope include:
Flexible robotic surgery: Flexible robotic surgery is a minimally invasive treatment option for some head and neck cancer patients that allows surgeons access to hard-to-reach areas of the mouth and throat using a flexible scope.
Laser surgery: In laser surgery, an endoscope with a high-intensity laser on the tip is inserted down the throat. The tumor can then be vaporized or removed using the laser.
Reconstructive microsurgery: It may be an option to reconstruct areas of the head and neck affected by cancer with reconstructive microsurgery. It may be possible to reconstruct the nose, tongue or throat using tissues from other areas of the body, such as the thigh, abdomen or forearm.
