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Head and Neck Tumors

• Larynx (including the supraglottis, glottis, and subglottis)

• Oral cavity (tongue, floor of mouth, hard palate, buccal mucosa, and alveolar ridges) • Oropharynx (posterior and lateral pharyngeal walls, base of tongue, tonsils, and soft palate) Less common sites include the nasopharynx, nasal cavity and paranasal sinuses, hypopharynx, and salivary glands. Other sites of head and neck tumors are • Intracranial tumors in adults and children

• Thyroid cancers

• Tumors of the orbit and cancers affecting the retina

• Acoustic neuromas

• Skin cancers

The incidence of head and neck cancer increases with age. Although most patients are between age 50 to 70 years, the incidence in younger patients is increasing, related to cancers (primarily oropharyngeal) caused by human papillomavirus (HPV) infection.

Head and neck cancer is more common among men than women at least in part because male smokers continue to outnumber female smokers and because oral HPV infection is more frequent in males.

Treatment

  • Surgery, radiation therapy, or both--Sometimes chemotherapy
  • The main treatments for head and neck cancer are surgery and radiation. These modalities can be used alone or in combination and with or without chemotherapy.
  • Many tumors, regardless of location, respond similarly to surgery and to radiation therapy, allowing other factors such as patient preference or location-specific morbidity to determine choice of therapy.
  • However, at certain locations, there is clear superiority of one modality. For example, surgery is better for early-stage disease involving the oral cavity because radiation therapy has the potential to cause mandibular osteoradionecrosis.
  • Endoscopic surgery has become more frequently used; in select head and neck cancers, it has cure rates similar to or better than those of open surgery or radiation, and its morbidity is significantly less.
  • Endoscopic approaches are most often used for laryngeal surgery and usually use a laser to make the cuts.
  • Endoscopic approaches also are being used in the treatment of selected sinonasal tumors.

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