Santa Rosa Head & Neck Surgery
Head and neck tumors are a class of benign (non-cancerous) or malignant (cancerous) lesions that develop in the facial skin, nose/sinuses, mouth, pharynx (throat), larynx (voice box), salivary glands, lymph nodes of the neck, thyroid gland, and parathyroid glands.
Tumors of the head and neck may present with a lump in the neck, lesion of the mouth, hoarseness, painful/difficult swallowing, or bleeding. However, most of the patients who present to SRHN with one of these complaints fortunately turn out not to have cancer.
Thorough and regular examinations help patients and physicians find abnormalities early, when treatment is usually most effective. If a mass is found, our doctors will perform tests to determine whether the tumor is benign (non-cancerous) or malignant (cancerous). This may involve imaging (MRI or CAT scan), fine needle aspiration, biopsy, endoscopy, or other tests.
Typically, a team of specialists will become involved in the care of a patient who has been diagnosed with a head and neck cancer. SRHN physicians provide surgical expertise (when necessary) and serve a central role in coordinating the team which may include radiation oncologists (radiation doctors), medical oncologists (chemotherapy doctors), radiologists, pathologists, dentists, and speech pathologists. Treatment options depend on the site and size of the tumor, involvement of other structures, and the patient’s overall health. Once the team of specialists has formulated treatment recommendations, SRHN physicians discuss all options with the patient in order to form a treatment plan compatible with the patient’s preferences.
Some surgical procedures which may be performed for head and neck tumors include:
- Salivary Gland Removal: The major salivary glands include the parotid glands (located in the face in front of the ear), submandibular glands (located in the neck below the jaw), and sublingual glands (located in the mouth under the tongue. These glands may be removed for chronic infection or suspected tumor. Most salivary gland masses turn out to be benign. Because the glands are numerous, removal of one of the salivary glands does not typically cause any noticeable decrease in saliva production. The nerves that control motion of the facial muscles lie in close proximity or even within the salivary glands. Our surgeons use delicate meticulous dissection technique and facial nerve monitoring equipment to minimize the risk of any trauma to these important nerves during the procedure. Our surgeons also use cosmetic surgery principles to disguise the incision scar.
- Neck Dissection (for large lymph nodes): A neck dissection is a procedure performed to remove all of the lymph node containing tissue of the neck. Hundreds of small lymph nodes are located throughout the neck and play a role in fighting infections of the head and neck. The lymph nodes also are typically the first place that a head and neck cancer will spread. Thus, enlarged lymph nodes may represent either infection or tumor. When a cancer extends to the neck lymph nodes (or when there is a high chance of undetected microscopic spread), a neck dissection may be used as part of the treatment plan. In this procedure, the surgeon removes all of the fatty tissue of the neck that contains the lymph nodes. This is accomplished by dissecting the fatty tissue away from many of the important structures of the neck such as muscles, cranial nerves, jugular vein, and carotid artery. Whenever possible, all of the normal structures of the neck are preserved to minimize dysfunction. Although this is a lengthy and intricate procedure, patients generally recover quickly with minimal discomfort. Speech and swallowing are not typically affected by a neck dissection procedure.
- Facial Skin Cancer Removal and Reconstruction: There are three main types of skin cancer. Most common (and least aggressive) is a basal cell carcinoma. This type of cancer never spreads to other areas of the body but does cause local tissue invasion and destruction. A basal cell cancer is easily cured when treated early but can cause significant deformity if untreated. The other types of skin cancer (squamous cell cancer and melanoma) have the potential to spread elsewhere in the body but typically are caught before this happens. Again, when treated early these types of cancer can be easily cured.A skin cancer typically presents as a slowly growing lesion of the sun-exposed areas of the face. The lesion may ulcerate, bleed, or crust over. Occasionally there is some itching or mild discomfort. A melanoma usually presents as a pigmented (colored) lesion. The color may be brown, purple, or black. Any mole that has irregular borders or color variations should be evaluated by a physician to rule out melanoma.If a skin cancer is diagnosed then our surgeons will remove the lesion either in the office or in the operating room. The excised lesion is examined by a pathologist in the laboratory to ensure that no microscopic disease was left behind. Once this has been verified, the wound is closed. For larger lesions, a skin graft or rotation of surrounding skin may be required to achieve closure. Our surgeons, specifically trained in facial plastic surgery techniques, will make every effort to ensure the best possible cosmetic outcome.
- Thyroidectomy (Thyroid surgery): is performed for one of three reasons. If an enlarged thyroid gland begins to compress surrounding structures of the neck, then symptoms of difficulty swallowing, shortness of breath, or hoarseness may occur. These “compressive symptoms” can be relieved with surgical removal of the thyroid gland. The second reason for thyroidectomy is when there is a suspicion for a cancer of the gland. Finally, the thyroid gland is removed in rare circumstances when a thyroid hormone imbalance cannot be controlled with medication alone.