Head and neck surgery is a subspecialty of ear, nose and throat (ENT) medicine that covers the surgical treatment of benign and malignant diseases of the mouth, tongue, pharynx, larynx, salivary glands, thyroid gland and neck. Because this region controls essential daily functions such as breathing, swallowing, speaking and facial expression, every operation aims to preserve function and appearance as well as treat the disease. This article summarizes when surgery is considered and how treatment proceeds.<\/p>\n
The head and neck is a complex region where many vital structures sit close together. Major blood vessels, the nerves that move the face and tongue, the start of the airway and digestive tract, and hormone-producing glands lie side by side. Head and neck surgery refers to operations on these structures, excluding the brain, eyes and spine.<\/p>\n
The field covers:<\/p>\n
The term “head and neck cancer” describes tumors that mostly develop from the cells lining the inner surfaces of these areas. However, much of this field deals with benign conditions; most salivary gland tumors and thyroid nodules are not malignant.<\/p>\n
The decision depends on the type and extent of the disease and the patient’s overall health. Common situations include the following.<\/p>\n
Most salivary gland masses occur in the parotid gland in front of the ear, and a large share of them are benign. The most common benign tumor, pleomorphic adenoma, grows slowly, but because it tends to enlarge over time and rarely becomes malignant, removal is usually recommended. The facial nerve, which moves the facial muscles, runs through the parotid gland, so these operations require careful protection of the nerve. In the gland under the jaw, recurrent stones and infections can also be a reason for surgery.<\/p>\n
Thyroid nodules that are suspicious for cancer, cause compression or produce excess hormone, as well as goiter, may require surgery. Parathyroid adenomas, which disrupt calcium balance, are also treated surgically in this region.<\/p>\n
Congenital cysts in children and persistent, unexplained lymph node enlargement in adults are the main reasons for neck mass surgery. In an adult, a neck swelling lasting more than a few weeks requires a thorough evaluation, as it may be the first sign of a tumor elsewhere.<\/p>\n
Tumors of the nasal cavity and sinuses are rare, and their symptoms can resemble sinusitis for a long time. One-sided, worsening nasal blockage, recurrent nosebleeds, facial numbness or swelling around the eye deserve attention. Many of these tumors can now be operated on endoscopically through the nose.<\/p>\n
Smoking and alcohol are the most important risk factors for head and neck cancers, and using both together markedly increases the risk. In recent years, the role of HPV infection, especially in tumors of the tonsils and base of the tongue, has become increasingly well understood. Seeing an ENT specialist is recommended if any of the following last longer than 2-3 weeks:<\/p>\n
The right treatment plan starts with a detailed evaluation. During the ENT examination, the mouth, pharynx, nasopharynx and larynx are inspected with a thin camera, and the neck and salivary glands are examined by hand.<\/p>\n
Tests may include:<\/p>\n
Treating head and neck cancer is the work of a team, not a single specialist. At tumor board<\/em> meetings, the ENT surgeon, radiation oncologist, medical oncologist, radiologist, pathologist, plastic surgeon, dentist, dietitian and speech and swallowing therapist review each patient together and decide on the most suitable treatment sequence. For some patients surgery is the first option; for others, radiation therapy or chemoradiotherapy comes first.<\/p>\n Quitting smoking, improving nutrition and, in patients scheduled for radiation therapy, assessing oral and dental health all help the treatment process go more smoothly. Heart or lung disease and diabetes are also addressed before anesthesia.<\/p>\n Most operations are performed under general anesthesia. Duration varies widely with the extent of the procedure: moderately extensive operations often take 3-4 hours, removal of a small mass takes less time, and major tumor operations requiring reconstruction can take longer. Incisions are placed wherever possible in neck creases or around the ear, where scars are less likely to be noticeable.<\/p>\n The operation for parotid gland tumors is called parotidectomy<\/em>. Depending on the tumor’s location, only the superficial part or the entire gland is removed. The facial nerve and its branches are identified and protected, and in many centers the nerve’s function is monitored in real time with electrical monitoring. For the submandibular gland under the jaw, the gland is removed through a small incision parallel to the lower edge of the jawbone, while the nerve branches that control tongue movement and the corner of the mouth are protected.<\/p>\n Head and neck cancers often spread first to the lymph nodes in the neck. A neck dissection is the planned removal of lymph nodes from specific areas together with the surrounding fatty tissue. Depending on the suspected spread and the tumor’s location, a selective<\/em> dissection removing only the at-risk areas or a broader modified radical<\/em> dissection may be performed. Today, whenever possible, structures such as the nerve that moves the shoulder, the main neck vein and the neck muscle are preserved.<\/p>\n For selected tumors of the larynx and pharynx, the tumor can be removed through the mouth with laser or robotic systems, without a neck incision. In suitable patients, these methods can help swallowing recover faster and shorten the hospital stay. Not every tumor is suitable, however; the decision depends on the tumor’s size and location.<\/p>\n Tissue defects left after extensive tumor removal are repaired so they do not impair speech and swallowing. Skin, muscle or bone taken from another part of the body (a flap) may be used for this. The repair is usually done in the same operation in which the tumor is removed.<\/p>\n Recovery varies greatly with the type of operation. After salivary gland, thyroid or neck mass surgery, patients usually stay in the hospital for 1-2 days and return to social life within about 2 weeks. After extensive tumor surgery requiring reconstruction, these times may be longer, depending on the individual.<\/p>\n Drains placed to remove fluid from the neck are taken out within a few days as drainage decreases. After mouth and throat surgery, eating starts with liquids and soft foods; after extensive operations, a thin feeding tube from the nose to the stomach may be used temporarily. Adequate calories and protein are important for wound healing.<\/p>\n For patients with swallowing or speech difficulties, exercises with a speech and swallowing therapist play an important role in regaining function. If shoulder weakness or stiffness develops after a neck dissection, physical therapy is recommended. Depending on the pathology result, some patients need radiation therapy or chemotherapy after surgery. Patients who have completed cancer treatment are followed with regular check-ups, more frequently in the early years.<\/p>\n Because the head and neck are closely tied to appearance and communication, treatment can also be emotionally challenging. Getting used to changes in voice, swallowing or facial appearance can take time. Family support, psychological counseling when needed and contact with others who have been through similar treatment can ease this adjustment. Many patients return to work and social life after treatment.<\/p>\n The length of stay in Istanbul depends on the extent of surgery and the overall plan agreed by the multidisciplinary team. After salivary gland, thyroid or neck mass surgery, planning roughly a week, until drain removal and the first wound check, is generally reasonable. Major tumor surgery, reconstruction or additional radiation therapy can require several weeks. Flying is generally postponed until wounds have healed and breathing and swallowing are stable, and your surgeon will advise on timing. Please bring previous reports, imaging and a medication list; follow-up can later be coordinated with your doctors at home.<\/p>\n The dense network of vessels and nerves makes these operations demanding. Risks vary by operation but generally include:<\/p>\n After surgery, seek medical attention without delay for shortness of breath, rapidly growing neck swelling, high fever, redness or discharge at the wound, or inability to swallow. Avoiding smoking and alcohol after treatment both supports healing and lowers the chance of a new tumor.<\/p>\n No. Many benign conditions, such as benign salivary gland tumors, thyroid nodules, congenital neck cysts and salivary gland stones, are also within this field. Cancer surgery is only one part of head and neck surgery.<\/p>\n Symptoms such as mouth sores, hoarseness and neck swellings can often be noticed early. Getting examined when such complaints last more than 2-3 weeks helps catch the disease at an earlier stage, when treatment options are generally broader.<\/p>\n Incisions are planned, as far as possible, along natural skin creases and in less visible areas, and scars usually fade over time. For some tumors, approaches through the mouth require no external incision at all.<\/p>\n No. A neck dissection is planned when cancer has spread to the lymph nodes or when the type and size of the tumor carry a high risk of spread. It may not be needed for some early-stage tumors.<\/p>\n That depends on the pathology result. The tumor board weighs information such as tumor size, surgical margins and lymph node involvement to decide whether additional treatment is needed.<\/p>\n Op. Dr. Tayfun Demirel, an ENT specialist, evaluates patients with neck swellings, salivary gland masses, thyroid nodules and suspected head and neck cancer at the practice in Ata\u015fehir, Istanbul, through examination and any necessary tests. Treatment options are planned individually, taking into account the type of condition and each patient’s needs. Please contact the clinic to book an appointment or for more information. This article is for informational purposes only; an in-person examination is required for diagnosis and treatment.<\/p>\n","protected":false},"excerpt":{"rendered":" Head and neck surgery is a subspecialty of ear, nose and throat (ENT) medicine that covers the surgical treatment of benign and malignant diseases of the mouth, tongue, pharynx, larynx, salivary glands, thyroid gland and neck. Because this region controls essential daily functions such as breathing, swallowing, speaking and facial expression, every operation aims to […]<\/p>\n","protected":false},"author":1,"featured_media":1174,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[37],"tags":[27,28],"class_list":["post-1368","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-throat","tag-bas-boyun-cerrahisi","tag-bas-boyun-kanseri"],"_links":{"self":[{"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/posts\/1368","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/comments?post=1368"}],"version-history":[{"count":1,"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/posts\/1368\/revisions"}],"predecessor-version":[{"id":2139,"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/posts\/1368\/revisions\/2139"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/media\/1174"}],"wp:attachment":[{"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/media?parent=1368"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/categories?post=1368"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tayfundemirel.com\/en\/wp-json\/wp\/v2\/tags?post=1368"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}How Is Head and Neck Surgery Performed?<\/h2>\n
Salivary Gland Surgery<\/h3>\n
Neck Dissection<\/h3>\n
Minimally Invasive Approaches Through the Mouth<\/h3>\n
Reconstruction<\/h3>\n
Recovery After Head and Neck Surgery<\/h2>\n
The First Days and Nutrition<\/h3>\n
Rehabilitation and Follow-Up<\/h3>\n
Adjusting to Daily Life<\/h3>\n
Notes for Patients Traveling from Abroad<\/h3>\n
Possible Risks and Important Considerations<\/h2>\n
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Head and Neck Surgery: Frequently Asked Questions<\/h2>\n
Is head and neck surgery only for cancer patients?<\/h3>\n
Can head and neck cancer be detected early?<\/h3>\n
Will I have a scar on my face or neck?<\/h3>\n
Does every cancer patient need a neck dissection?<\/h3>\n
Will I need radiation therapy after surgery?<\/h3>\n
Conclusion<\/h2>\n