The most common surgical procedures for the removal of oral and oropharyngeal cancer include:
What is Primary tumor surgery?
It removes the tumor and a margin of healthy tissue around it to reduce the chance that any cancer cells will be left behind. The tumor can be removed through the mouth, or through a neck incision. A mandibulotomy may be necessary in which the jawbone is split to allow the surgeon to access the tumor.
What is Glossectomy?
A glossectomy for oral cancer involves removing part or all of the tongue. It may be used to treat tongue cancers, some oral cavity, and cancers of the throat.
What is Mandibulectomy?
If the tumor has reached a jawbone but has not spread to the bone, either a portion of the jawbone or the whole jawbone is removed. When there is evidence of jawbone damage on an x-ray then it might need to remove the entire bone.
What is Maxillectomy?
The procedure removes some or all of the hard palate which is the mouth’s bony roof. Prostheses (artificial devices) can be placed using soft tissue flaps with and without bone to fill the gaps produced during this surgery.
What is Neck dissection?
Oral cavity and oropharyngeal cancer also spread across the neck to lymph nodes. Preventing cancer from spreading to the lymph nodes is a primary treatment objective. Some or all of these lymph nodes may need to be removed using a surgical procedure called a dissection of the neck, even if the lymph nodes do not show any evidence of cancer when examined. Radiation treatment or a combination of chemotherapy and radiation therapy, called chemoradiation, can be accompanied by a neck dissection to ensure there is no cancer left in the lymph nodes. Often, neck dissection following radiotherapy for oral cancer or chemoradiation is advised for oropharyngeal cancer.
What is Laryngectomy?
A laryngectomy is the removal of the larynx or the voice box in whole or in part. Although the larynx is important for sound production, it is also critical for the larynx to swallow because if it protects the airway against food and liquid entering the trachea or windpipe and reaching the lungs which can cause pneumonia. Rarely laryngectomy is needed to treat oral or oropharyngeal cancer. Nevertheless, when tongue or oropharynx is large tumor, the doctor may need to remove the larynx during swallowing to protect the airway. If the larynx is removed, the windpipe is re-attached to the neck skin where a hole is made that is called a stoma or tracheostomy.
What is Transoral robotic surgery vs. Transoral laser microsurgery?
Transoral robotic surgery (TORS) and transoral laser microsurgery (TLM) are minimally invasive operations. This means they don’t require large cuts to get to a tumor and remove it. An endoscope is used in TORS to see a tumor in the throat, the tongue base and the tonsils. Then 2 tiny robotic instruments act as the arms of the surgeon to remove the tumor. In TLM, an endoscope is placed through the mouth attached to a laser. The laser is then used to extinguish the tumor.
What is Micrographic surgery for oral cancer?
This type of surgery is often used to treat skin cancer, and can sometimes be used for tumors of the oral cavity. It may reduce the amount of lost healthy tissue. Often this technique is used in lip cancer treatment. In addition to small fragments of tissue surrounding the tumor, this involves removing the visible tumour. Each small fragment shall be examined under a microscope until all cancer is removed.
What is Tracheostomy for oral cancer?
If cancer blocks the airway or is too large to remove completely, a hole in the neck is made. This opening is known as tracheostomy. Thereafter, a tracheostomy tube is placed, and a person breathes through it. A can be temporary or permanent tracheostomy.
What is Gastrostomy tube for oral cancer?
If cancer prevents a patient from swallowing, a feeding device is mounted called a gastrostomy tube. The tube passes through the skin and muscle of the abdomen and through the stomach directly. These tubes may be used as a temporary way to preserve nutrition before the person is able to safely and properly swallow food that is taken in through the mouth. A nasogastric (NG) tube may be used to relieve temporary issues instead of a tube into the stomach. The NG tube is inserted into the stomach through the nose, down the esophagus.
What is Reconstruction?
Reconstructive surgery may be required to help the patient swallow and talk again if treatment requires removing large areas of tissue. It is possible to take healthy bone or tissue from other parts of the body to fill holes left by the tumor or to remove part of the lip, tongue, palate or jaw. A prosthodontist may make an artificial dental or facial part to help swallow and speak. A speech-language pathologist can teach the patient to communicate using new techniques or special equipment and can also help restore the ability to swallow after surgery or after radiation therapy in patients who have difficulty eating.
What is recovery like after oral cancer surgery?
You may need to stay in hospital for a couple of days following surgery. How long you stay in hospital depends on how much and what part of your oral cavity has been removed. Most people are permitted to go home after surgery for oral cancer within few days. Mostly it will take a few weeks for you to feel better. You will still need some special care after you have left the hospital while you recover from the surgery.
Common side effects of oral cancer after surgery include:
- Tiredness
- Pain
- Bleeding
- Symptoms from lymph node removal such as shoulder weakness, ear numbness, or weakness in your lower lip
- Diarrhea
- Constipation
- Bloated face
You may need extra care in some cases after the surgery. When you have a tracheostomy, a physical or respiratory therapist will be able to give you exercises to encourage breathing. He or she will teach you and your caregivers how to take care of the tracheostomy as well. When you have a gastrostomy tube, you and your caregivers should be taught how to use the tube by a nurse or therapist You can have a while in the gastrostomy tube, before you can swallow well enough to feed again. If your treatment prevents you from swallowing well again, you will still be able to feed yourself with a gastrostomy tube.
You might run into trouble eating. A nurse or therapist will help you learn how to swallow, so that after surgery you can eat. As part of the surgery, you may have had to have teeth removed. Many individuals have dental problems that their dentist or oral surgeon addresses after they have healed from their cancer treatment. After surgery there are several ways to restore the teeth.
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