Surgery is an important treatment for most head and neck cancers. We use the latest techniques to remove your tumors and restore your appearance and function.
Surgeons at the Otolaryngology–Head and Neck Surgery Center at University of Washington Medical Center (UWMC) treat SCCA patients. They are national leaders in head and neck cancer surgery, performing a high volume of complex procedures every year.
Depending on the specific features of your cancer, you might have:
- Minimally invasive surgery
- Traditional open surgery
- Reconstructive surgery
Minimally invasive head and neck surgery
Minimally invasive procedures are usually used for upper-airway tumors. These procedures are done through your mouth or nose so you don’t need incisions in your face or neck. Whenever possible, our surgeons opt for this method. Patients typically return home in only a day or two.
Your surgeon may use a variety of tools and technologies to assist with your surgery. For example, they may use a thin tube with a light and a lens (endoscope) to reach a tumor through your mouth and remove it with a laser (transoral laser microsurgery).
The newest technique for tumors at the back of the tongue or in the throat is transoral robot-assisted surgery (TORS), also called transoral robotic surgery.
- Removing these tumors used to require a large incision in the neck and lower jaw, and many patients had trouble swallowing or speaking afterward.
- Now, using the da Vinci Surgical System, or da Vinci robot, we can remove tumors in this area through your mouth. UWMC was the first to bring robot-assisted surgery using da Vinci to our region.
- Your surgeon uses hand and foot controls to move robotic arms that hold a camera and surgical instruments.
- The system allows your surgeon to perform very precise, complex motions.
Traditional open surgery
If minimally invasive surgery is not an option for you because of your tumor’s location or size, your surgeon will use a traditional open approach, making an incision in your face or neck. This type of surgery may be more involved and take longer. Your recovery may take longer as well.
With new open techniques, surgeons strive not only to remove the cancer (and lymph nodes, if needed) but also to avoid disturbing important nerves, muscles and blood vessels in your neck and shoulder area.
Not everyone who has surgery to remove head or neck cancer needs reconstructive surgery. But for those who do, UW Medicine reconstructive surgeons are experts in their field.
State-of-the-art reconstruction can help to minimize changes in your appearance caused by your cancer or your treatment.
- Using a team approach, your oncology surgeon and a reconstructive surgeon will work together during one operation to both remove your cancer and complete any reconstruction you need.
- The combined operation means you’ll be under anesthesia and in surgery for significantly less time that you would be for two separate operations.
- After surgery, a team of nurses, speech pathologists and social workers will help you recover and rehabilitate.
One reconstructive technique is free-flap surgery, in which surgeons remove skin, bone or other tissue from one part of your body to reconstruct another part. For example, if you need part of your jaw removed, UW Medicine surgeons may reconstruct your jaw using bone from your leg, hip or shoulder blade. Even your tongue can be reconstructed with tissue from another part of your body.
Great advances have been made in using prosthetics to restore parts of the body that need to be altered or removed.
- For patients who have their larynx removed, doctors can implant a tracheoesophageal puncture prosthesis (TEP) in a small hole made between your windpipe (trachea) and esophagus. A TEP restores your ability to deliver air from your lungs into your throat to produce speech.
- Another option for restoring vocal ability is an electrolarynx — a device placed against your neck to help produce sound that comes out through your mouth.
We will do everything we can to prevent or minimize side effects you might experience from surgery and will provide care to help you heal well and deal with any side effects that do occur.
If surgeons cannot save or restore certain important structures while also removing your cancer, or if you have trouble with chewing, swallowing, speaking or other functions after surgery, we have specialists to help. They include speech and swallowing pathologists, physical therapists, occupational therapists, dietitians and lymphedema specialists (who perform specialized massage and compression to manage chronic swelling called lymphedema). Your team will talk with you in detail about your unique situation, what to expect and what treatments or services might help you.
Your pathology report, which provides details about the tissue that was removed, will be available when you return in a week for a follow-up visit with your surgeon. Decisions about any further cancer treatment, such as radiation therapy or chemotherapy, will be based on the findings in your report, including:
- What kind of tumor you had
- How large it was
- Whether all of the cancer was removed
- Whether cancer had spread to lymph nodes in your neck