Surgery in the head and neck area may be required to treat a number of conditions.
Thyroid Gland Removal
When certain conditions interfere with normal thyroid production, surgical removal of the thyroid gland is performed. This is usually done when thyroid cancer has been detected, an otherwise benign thyroid nodule grows so large it causes problems or hyperthyroidism (a disorder in which excess thyroid hormone is produced) does not respond to treatment with medications or radioactive iodine, though this is rare.
Thyroid surgery is known as a thyroidectomy. Two types of procedures are performed: a total thyroidectomy to remove the entire gland or a subtotal thyroidectomy, which removes part of the gland.
In a total thyroidectomy, the entire gland and surrounding lymph nodes are removed. The patient is given drugs to suppress thyroid hormone production, in addition to radioactive iodine. A subtotal thyroidectomy involves removal of one complete gland and part of the other, which is usually reserved for treating hyperthyroidism caused by Grave’s disease.
Lymph Node Biopsy
Lymph nodes are bean-shaped glands located in your neck, armpits, groin, chest and abdomen. They are part of your immune system and contain white blood cells that help fight off infections. Lymph nodes can become enlarged because of a viral infection, bacterial infection or an infection located somewhere else in your body; cancer can also cause enlarged lymph nodes.
In order to determine the cause of your lymph node enlargement, your doctor may order a biopsy. This procedure involves removing a small amount of lymph node tissue, which will then be looked at under a microscope. Below are the most common types of lymph node biopsies:
- Fine-needle aspiration biopsy. This quick procedure involves inserting a thin needle into the lymph node and removing a sample of cells.
- Core needle biopsy. This involves inserting a needle with a special tip into the lymph node and removing a rice-sized portion of issue. A core needle biopsy takes about 20 minutes.
- Open (surgical) biopsy. This requires your doctor to make a small cut in your skin and remove a lymph node. This process allows your doctor to take a bigger sample than a needle biopsy could collect. An open biopsy takes about 30 to 60 minutes to complete; if this biopsy is performed to remove cancer then it may take longer.
Parotid Cancer Treatment
The salivary glands are responsible for producing saliva to help you digest food and protect against infections. There are three pairs of major salivary glands; the largest of those, the parotid glands, are found just in front of each ear. Most forms of salivary gland cancer begin in the parotid gland.
To test for parotid cancer, your doctor will give you a thorough physical exam, paying special attention to the head, neck, mouth and throat. If a tumor is suspected, tests will be administered; these might include a CT scan, MRI, PET scan, ultrasound and endoscopy. A biopsy will be performed to look for cancerous cells in the tissues. If cancer is confirmed, your doctor will determine its stage in order to recommend a plan for treatment.
Treatment for parotid cancer depends on the type, size and stage of the cancer. Surgery is a common treatment, and may involve removing all or part of the salivary gland or removing lymph nodes in the neck. Radiation therapy relies on using x-rays or other high-powered beams to deliver radiation directly to cancer cells, in order to kill them. Chemotherapy uses drugs to kill cancer cells.
Head & Neck Cancer
Head and neck cancers are those that grow in and around the throat, larynx, nose, sinuses and mouth. The majority of these cancers are squamous cell carcinomas that form in the cells lining the mucosal surfaces of the head and neck. They often spread to the lymph nodes, but are highly curable if discovered early.
Treatment depends upon several factors. The size and location of the tumor, its stage, and your age and health must all be taken into consideration. Our team at Pinnacle ENT will make a decision based on these unique factors. Options might include surgery, radiation therapy, chemotherapy, targeted therapy or a combination of the above.
A number of masses may develop in your head or neck. While some head and neck masses are cancerous, many are not. It is important to see a physician if any abnormal bump or lump persists for more than two weeks.
A simple examination of some masses may allow a physician to determine their cause based on location, size and consistency. In other cases, additional tests may be required. These tests include:
- MRI: Magnetic Resonance Imaging can clearly show tumors near bones, smaller tumors and brainstem masses. It uses a magnetic field rather than x-ray radiation.
- CT Scan: Computed Tomography combines a sophisticated x-ray with computer technology. It is less accurate than an MRI but can help locate tumors or determine their types, detect swelling or bleeding and evaluate the effects of treatments. Injections of an iodine dye contrast material may be used to enhance the visibility of abnormal tissue during CT scans.
- PET (Positron Emission Tomography) and SPECT (Single Photon Emission Tomography): are useful after diagnosis to help determine the grade of a tumor or to distinguish between cancerous and dead scar tissue. They involve injections with a radioactive tracer.
- Biopsy: A sample of tissue is taken and examined under a microscope to determine if it is malignant.
Treatments are determined by the cause of the mass. Benign neck cysts and masses are usually removed by surgical excision. Head and neck cancers may be treated by some combination of radiation therapy, chemotherapy and surgery, depending on their nature.