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Head and Neck Cancer Surgical Procedures

Head and Neck Cancer Australia has developed information sheets for the different types of head and neck surgical procedures. You may want to download the relevant information sheet and discuss it with your patient during their consultation. These information sheets can also be found on the central Resource page.

craniofacial resection 

This involves removing the cancer using cuts (incisions) via the face and the skull. It is used for cancers that have grown inside, or approach the skull.
 

dental extraction 

Tooth extractions may be recommended to remove any broken or infected teeth before radiation therapy. This is important because removal of unhealthy teeth after radiation therapy can cause problems with the jaw bone.
 

endoscopic sinus surgery

This is where a telescope and surgical instruments are passed through the nose to get to the nasopharynx without external cuts.
 

feeding tubes

  • A gastrostomy tube (called a PEG tube) goes through the skin and the muscles of your abdominal wall into the stomach. Gastrostomy is recommended if feeding is needed for a medium to longer time (months or years).
  • A nasogastric tube goes through the nose down into the stomach. Nasogastric feeding is used for short time (days or weeks). 

Glossectomy

This involves removing part of, or all of the tongue. It is used if the cancer is growing in the tissue of the tongue.
 

hypopharyngectomy

This is removal of part of the hypopharynx via an open neck approach. 
 

lateral temporal bone surgery 

This is the removal of some or all of the bone in the temple and behind the ear. It is used when a cancer in the parotid glands spreads into the nearby bone.
 

local excision 

This operation involves cutting out the skin cancer with a margin of healthy tissue to ensure all of the cancer is removed. It may require cutting away skin, or other soft tissue and bone. 
 

lymph node & sentinel node biopsy

This is an investigation that may be done at the time a skin cancer is treated. It is done when there is a high risk of the cancer spreading to lymph nodes, but no nodes are obviously involved. This is most often done in people with melanoma or MCC and rarely done for people with SCC or BCC.
 

mandibular lingual release 

This is when a cut or incision across the upper part of the neck and another cut inside the mouth is made to allow the surgeon to access and remove cancer in areas such as the mouth, including the tongue and part of the throat located just behind the mouth called the oropharynx. 
 

mandibulectomy

This involves removing part of the lower jaw (mandible). It is used if the cancer has spread into the bone of the jaw or is next to the jaw.
 

mandibulotomy

This involves cutting the jaw bone to allow better access to the cancer in the mouth. This may be needed if the cancer is further back and difficult to reach through the mouth. The jaw is put back together at the end of the operation with titanium plates.
 

maxillary swing approach

This is where a cut is made in the upper lip and next to the nose, and the upper jaw is cut to allow the surgeon to get access to the nasopharynx.
 

maxillectomy

This involves removing part of the upper jaw (maxilla), in the roof of the mouth. It is used when the cancer is affecting the roof of the mouth or upper gums.
 

NECK DISSECTION

This involves removing lymph nodes from the neck. It is used when oral cancer has spread to the lymph nodes in the neck or there is a risk of cancer in the lymph nodes of the neck.
 

Orbital exenteration

This is the removal of the soft tissue of the eye and eyelid. It is used when a cancer has spread into the skin near the eye and cannot be treated any other way.
 

ORopharyngectomy 

This is the removal of part of the oropharynx, which is usually done for cancer of the oropharynx. 
 

PArotidectomy

This is the removal of one or both of the parotid glands (pair of major salivary glands located in front of each ear) and the surrounding tissue. 
 

PArtial laryngectomy

This is the removal of part of your larynx. 
 

PHaryngo-oesophagectomy

This involves removing cancer located in the lower throat (hypopharynx) and the top part of the oesophagus.
 

RAdical parotidectomy (Facial nerve sacrifice)

This is removal of facial nerve, which controls facial expression. It is performed when a cancer in the parotid glands has spread to surrounding facial nerve.
 

reconstructive surgery (regional flap)

This involves removing lymph nodes from the neck. It is used when oral cancer has spread to the lymph nodes in the neck or there is a risk of cancer in the lymph nodes of the neck.
 

reconstructive surgery (bony free flap flap)

This may be required after surgery to remove cancers from the upper and lower jaw, they are called ‘bony’ because they involve taking bone from somewhere else in the body.There are many different types of bony free flaps, which use different types of tissue depending on what is needed for the reconstruction.  
 

reconstructive surgery (soft tissue free flap)

This may be considered if you have a large area of tissue removed. This may involve taking tissue from another part of the body, this is called a free flap repair. This operation is carried out by a surgeon who specialises in reconstructive surgery, your head and neck surgeon or another surgeon.
 

Simple reconstruction (Local and Skin graft repair)

This may be considered to rebuild the area if a large amount of tissue or bone was removed during surgery. 
  • Local flap repair: uses a piece of tissue with its own blood supply from an area near the wound. The piece of tissue close by is moved or roated so that it then covers the wound.
  • Skin grafts: use a thin layer of healthy skin from another part of the body to cover the wound. A thin sheet of skin is taken from somewhere not too obvious, such as the thigh or forearm and is put over the area that needs to be covered. 
 

SISTRUNK

A sistrunk procedure involves removal of the thyroglossal cyst, part of the thyroid bone and some more tissue
 

SUbmandibular gland  surgery

This is the removal of the submandibular glands (located beneath the floor of your mouth) and some of the surrounding tissue and/or bone. 
 

sublingual gland surgery

This is removal of the sublingual glands (located in the mouth) and some of the surrounding tissue.
 

THyroidectomy

This is the removal of the thyroid gland from the neck. If the entire thyroid gland is removed, it is called a total thyroidectomy. If only some of the thyroid gland is removed, it is called a partial or hemi-thyroidectomy. 
 

Tonsillectomy

This involves removing the tonsils, if there are signs of cancer in the tonsils or other lymph nodes in the neck. It can also help with diagnosing the type of cancer.
 

Total laryngectomy

This is the removal of all of the larynx.
 

Total laryngopharyngectomy

This is the removal of all the larynx and pharynx. It is different to laryngectomy, where only the larynx (or part of it) is removed.
 

tracheostomy

A tracheostomy is used to create an opening in the trachea (windpipe) after major head and neck surgery. A tube is inserted into the opening to help you breathe until normal breathing is possible.
 

trans-oral robotic surgery

Sometimes, oropharyngeal cancers can be removed through the mouth without any external cuts using a robotic system or by using laser surgery.
 

trans-oral laser surgery

This is a minimally invasive approach to remove early hypopharyngeal cancers.
 

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