2023-05-25 07:51:34
▶ Park Seong-oh, professor of plastic surgery at Hanyang University Hospital
Park Seong-oh, professor of plastic surgery at Hanyang University Hospital. [한양대병원 제공]
Head and neck cancer is still an unfamiliar cancer. The head and neck area refers to the area of the neck, nose, mouth, and ears, excluding the eyes, from the bottom of the brain to the top of the chest. Head and neck cancer is a general term for cancers that occur here. If cancer develops here, problems with breathing, food intake, and vocalization occur, greatly reducing the quality of life and increasing the risk of disability. Head and neck cancer surgeons cut out the cancerous area as much as possible to prevent recurrence, but the functional and cosmetic aspects cannot be ignored. In this case, if you cooperate with a head and neck cancer reconstructive surgery specialist, you can not only remove the head and neck cancer, but also minimize recurrence, and satisfy the function and aesthetic aspects of the affected area. I met Park Seong-oh, a professor of plastic surgery at Hanyang University Hospital, who specializes in head and neck cancer reconstruction. . Professor Park said, “Reconstructive surgery for head and neck cancer does not simply recreate the shape of the removed biological tissue, but also takes into account the function and aesthetic aspects.” At the same time, reconstructive surgery can protect the patient’s quality of life.”
– When should I suspect head and neck cancer?
Changes in voice for more than 6 weeks, sores in the mouth that do not heal for more than 3 weeks, swelling in the mouth for more than 3 weeks, difficulty swallowing for more than 3 weeks, persistent blockage in one nostril or unusual discharge; If teeth are shaking regardless of periodontal disease, but it is difficult to determine the cause, if a mass in the neck area lasts for more than 3 weeks, if cranial nerve palsy and a lump in the orbital hole, or if this feeling of fullness persists for more than 3 weeks, head and neck cancer is suspected. You need to find a specialist.
– What are the benefits of performing reconstructive surgery at the same time as head and neck cancer surgery?
The standard treatment for head and neck cancer is to extensively resect the cancerous area while simultaneously removing the cervical lymph nodes that have metastasized or are highly likely to metastasize. However, if surgery is performed, vocalization and swallowing may not be performed properly. For this reason, efforts have been made over the past few decades to remove tumors while preserving this function.
Currently, except for some advanced cancers, conservative surgical methods that completely excise only the tumor while preserving the larynx and pharynx have become common. With the development of reconstructive surgery using ‘free flap’, it is possible to maintain some function even after large excision of head and neck cancer.
Recently, ‘Robotic Oral Surgery’, which performs robotic surgery through the oral cavity, has been developed, enabling patients to reduce the probability of disease (morbidity) and loss of function. In the case of advanced laryngeal and pharynx cancer, ‘induction chemotherapy’ and ‘concurrent chemotherapy and radiation therapy’ show similar treatment results to previous surgical methods, while preserving the larynx and pharynx, so it is also used as a first-line treatment. However, there are times when the preserved larynx and pharynx do not function properly, so careful selection is necessary.
-What is the role of a plastic surgeon performing reconstructive surgery for head and neck cancer?
When the cancer is removed through head and neck cancer surgery, various parts disappear. For example, in the case of head and neck cancer in the maxillary sinus, the nasal cavity, roof of the mouth, and sometimes the skin disappear, and the divided areas connect to each other.
So unless you have reconstructive surgery, you won’t be able to eat, talk, or breathe. At this time, the plastic surgeon in charge of reconstruction separates the nasal cavity, the roof of the mouth, and the skin and performs surgery to return it to its original state.
Another example is hypopharyngeal cancer surgery, which makes the cervical esophagus disappear. Then the patient will not be able to eat food through the mouth. Plastic surgeons perform reconstructive surgery to make it possible to eat through the mouth. Reconstructive surgery is performed by removing the entire skin tissue (flap), including blood vessels from other parts of the patient, and connecting it to the skin defect. It is a high-level operation that connects (anastomosis) blood vessels of about 1 to 2 mm. The operation takes a lot of time and is very difficult, so the operation must be performed delicately to avoid complications. Research continues to show that the success of reconstructive surgery affects the patient’s survival rate and prognosis (treatment progress).
-Why should reconstructive surgery be delicate?
To reduce complications after head and neck cancer surgery. For example, a skin fistula may occur as a complication after surgery for tongue cancer or pharynx cancer. Then, the saliva in the mouth continues to leak through the skin, drastically reducing the patient’s quality of life. These skin fistulas start with very small wounds. Head and neck cancer reconstructive surgery is often sutured in a very narrow and deep area where it is difficult to secure a field of vision.
Daeik Kwon Medical Specialist Reporter>
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