Head and Neck area Cancer
Head and neck area cancer types include cancer of the lips, oral cavity, nose and paranasal sinuses, pharynx and larynx as well as malignant tumours of the large salivary glands. A plastic surgeon participates in the treatment of cancer, when surgical repair of tissue shortage is needed. At Tays, we perform approximately 50 such surgeries annually.
Most often the surgery involves tissue shortage repair of the tongue, oral cavity or jaw with a flap. The goal is a sufficiently extensive tumour removal to prevent cancer recurrence and a repair of tissue shortage with the best possible functional and aesthetical end result.
Planning surgical treatment at Tays
If a doctor diagnoses a patient with cancer of the oral cavity, tongue or jaw area, he/she sends the patient case to be processed at the specialist meeting. At the meeting, ear, nose and throat disease specialists, an oncologist, radiologist and jaw and plastic surgeons plan the patient’s surgical treatment.
Reconstructive surgery is demanding because it is challenging to achieve a good aesthetic and functional end result. We apply different imaging methods and 3D modelling in the planning process.
Reconstructive surgical treatment
Typically, the patient arrives at the ward on the day preceding the surgery. The plastic surgeon visits the patient at the ward, goes over his/her share of the surgery and makes the necessary skin markings.
In the surgery, the cancerous tumour is removed and, simultaneously, the plastic surgeon detaches the necessary tissue transplant. After that, the tissue transplant is placed over the tissue shortage area, shaped to the correct form and connected to the circulation. Samples are also taken during the surgery to be examined by a pathologist.
The scope and duration of the surgery vary greatly according to cancer size, location and possible spread. The surgery is a major procedure.
Post-operative recovery at the ward usually takes from a few days to a week. If the surgery has made use of a flap, the patient spends the first day in the intensive care unit and, then, 5–7 days at the ear diseases ward.
Further treatment and monitoring
When the pathologist’s statement on the cancerous tumour is ready, we process it at the specialists’ meeting and decide on further treatment in a preliminary manner. If necessary, we refer the patient to the Tays Oncology Department to receive radiation or chemotherapy, or to somewhere else according to the individually selected plan.
The follow-up monitoring usually lasts 5–10 years. At first, the control visits are scheduled every 3–6 months and later on every 1–2 years. In connection with the control visits, imaging is performed to check that the tumour has not recurred or sent metastases.
Further controls take place at the outpatient clinic of Tays or at the patient’s own central hospital. Further monitoring depends on the disease diagnosis, tumour size and location.
Rehabilitation of speech, voice and swallowing
The rehabilitation of head and neck area surgery patients requires multi-professional cooperation. Swallowing, speech and voice rehabilitation services at the ward are provided by a speech therapist.
The rehabilitation process involves pre-operative information and a post-operative examination, rehabilitation at the ward, arrangement of further rehabilitation and the acquisition of the necessary assistive devices, such as speech vibrators and amplifiers, and instructions for their use.
The speech therapist may also participate in the patient’s working ability, retirement and further rehabilitation assessments together with the attending doctor and a social worker.
Group rehabilitation
A speech rehearsal group is organised at the phoniatry outpatient clinic for patients treated for cancer. The instructors of the group include a physiotherapist and trained speech instructors who have undergone similar treatment procedures. The purpose of the group is to facilitate adjustment to the new situation in life.