Head and Neck Leaflets

Facial Skin Lesions
A facial skin lesion refers to an abnormality in the skin’s appearance, such as a lump, crack, ulcer, or unusual discoloration that is not typically present. Lesions are classified as benign if they are harmless, while malignant lesions indicate the potential presence of skin cancer and pose a danger. While the majority of skin lesions are benign, there is a possibility that some may be malignant. Benign skin lesions may be visually unappealing or prone to repetitive damage, particularly during activities like shaving.
Flexible Nasal Endoscopy
Flexible nasal endoscopy is a common medical procedure employed to examine the interior of the nose, the nasal passages, the voice box, and the posterior regions of the throat and tongue. This diagnostic method utilizes an endoscope, which is a flexible type of telescope. The procedure is routinely conducted in various settings such as outpatient clinics, hospital wards, or emergency departments. Anyone experiencing issues related to the ear, nose, throat, or voice box may be recommended to undergo flexible nasal endoscopy to facilitate diagnosis and appropriate medical management.
Head and Neck Cancer
Head and Neck (H&N) cancer encompasses a range of malignant tumors that develop in various areas, including the mouth (oral cavity), throat (pharynx), voice box (larynx), salivary glands, and the nose and sinuses. In certain H&N cancer centers, the H&N cancer team may also address cancers affecting the skin of the scalp, face, and neck. It’s important to note that cancer of the thyroid gland is discussed separately from Head and Neck cancers.
HPV and throat cancer
There are over 100 types of HPV viruses that can infect the human body. HPV infections are common, but in most cases, the body’s immune system can clear the virus. These infections can remain dormant for many years before causing issues. Certain HPV types can lead to the development of warts, while others, specifically HPV 16 and 18, are associated with an increased risk of cancers. In young adults, HPV throat infections are common, and the majority clear without symptoms. However, a small proportion of individuals who do not clear the virus may develop throat cancer many years later. Fortunately, Head and Neck cancers caused by HPV tend to have positive outcomes. To prevent HPV-related diseases, the HPV vaccine is offered to children between the ages of 12 and 13 in the UK.
Microlaryngoscopy: an operation on your voicebox
Microlaryngoscopy is a thorough examination of the voice box, or larynx, conducted while the patient is asleep under general anesthesia. This brief procedure typically lasts around 30 minutes and may be accompanied by another operation known as pharyngoscopy and upper esophagoscopy, depending on the specific case. If applicable, additional details can be found in the patient information leaflet on Pharyngoscopy and upper esophagoscopy. The primary purpose of microlaryngoscopy is to identify and address issues affecting the voice box, such as determining the cause of a hoarse voice or investigating any abnormalities observed in the larynx.
Neck Dissection
Neck dissection comes in two basic types: Radical Neck Dissection involves surgically removing all lymph nodes between the jaw and collarbones when there is evidence of cancer in the neck nodes. This may entail removing additional tissues to ensure complete cancer removal, focusing on structures that won’t have serious lasting effects. On the other hand, Partial Neck Dissection is performed when there are suspicions of only microscopic cancer cells. It selectively removes specific groups of nodes most likely to be affected. In both procedures, all removed tissues are sent to the lab for examination to identify cancer cells and assess their spread.
Neck lump clinic
During your appointment with an ENT specialist for neck lump symptoms, they will inquire about your symptoms and conduct a comprehensive examination of your ear, nose, throat, and voice box to identify any additional issues. The specialist will gather information about your smoking and alcohol habits, general symptoms like weight loss, your medical history, current medications, and physical activity levels. Expect a thorough examination of your neck, so wearing a top that exposes your neck is recommended. Additionally, examinations of your throat, ears, and nose, including the possibility of flexible nasal endoscopy (as detailed in the next section), may also be part of the evaluation.
Parotidectomy – Surgery to remove a lump
The parotid gland, located in each cheek just in front of the ears, is the largest among the three main saliva-producing glands in your face. With one on each side, these glands play a crucial role in saliva production. Small tubes within the parotid glands transport saliva into the mouth, complementing the hundreds of small glands inside your mouth that also contribute to saliva production. Saliva serves essential functions such as maintaining dental hygiene by keeping teeth clean and initiating the breakdown of food as you chew.
Rigid pharyngoscopy and upper oesophagoscopy
Pharyngoscopy involves examining the throat, and oesophagoscopy involves examining the oesophagus (or gullet) under general anaesthetic. This procedure is conducted to investigate gullet-related issues, particularly difficulties or pain during swallowing. In some cases, it may be urgently performed to remove obstructive items like dentures or food lodged in the gullet. Oesophagoscopy is typically a brief operation. Additionally, another procedure, microlaryngoscopy or rigid laryngoscopy, may be performed simultaneously, and specific information on microlaryngoscopy will be provided by your surgeon if applicable.
Submandibular gland excision – Surgery for infection and/or recurrent blockage
The submandibular gland, the second-largest among the primary salivary glands, is about the size of a walnut and is positioned just below the jawbone on both sides of the neck (refer to Figure 1). Responsible for saliva production, this gland releases saliva through a duct (tube) that drains into the front of the mouth beneath the tongue.
Thyroid lumps and thyroid surgery – Diagnostic hemithyroidectomy
Situated in the neck, in front of the windpipe, between the collarbone and the Adam’s apple, the thyroid gland resembles a bowtie or butterfly (refer to Figure 1). Comprising two halves, the right and left thyroid lobes, connected by a bridge of tissue called the isthmus, this gland plays a vital role in hormone production. The thyroid gland produces thyroxine, a hormone released into the bloodstream that plays a crucial role in regulating metabolism.
Thyrotoxicosis – Thyroid surgery for benign thyroid disease
Controlling high thyroxine levels is often achieved through medication, but if medication proves ineffective, surgery may be necessary. Surgery may also be recommended in cases where thyroid eye disease results in significant symptoms. Following surgery, lifelong thyroxine replacement tablets are typically required. It’s important to note that changes in voice may occur after surgery, and while this is usually temporary, in rare cases, it can be permanent. Additionally, extremely low calcium levels can lead to symptoms like pins and needles and muscle cramps, constituting a medical emergency. In such cases, immediate contact with the surgical team or attendance at the nearest Emergency Department is crucial.
Trans-oral robotic surgery for head and neck cancer
Trans-oral robotic surgery, or TORS, is a throat surgery conducted through the mouth under general anesthesia, assisted by robotic technology. TORS utilizes a 3D high-definition camera and specialized jointed instruments that mimic human wrist movements. This technology enhances visibility and access to challenging areas, such as the base of the tongue, lower part of the tonsils, and the region above the voice box. The surgeon operates these instruments from a console, typically positioned in a corner of the operating room, ensuring full control throughout the procedure. An assistant surgeon remains by the patient’s side throughout the operation.