Head and neck surgery – New at the HPA

The head and neck surgery consultation, a subspecialty of otorhinolaryngology, has been operational since September last year at HPA Gambelas, under the medical responsibility of Dr Carlos E. Nabuco.

Tumours, inflammations or congenital diseases are part of his area of intervention, all with the common denominator of being located in the region of the head and neck.

Head and neck surgery is a multidisciplinary medical-surgical approach that treats benign and malignant diseases (cancers) in the region of the head and neck, with the exception of the central nervous system and spine.

The most important and/or common surgical diseases of the head and neck are: cancer of the lips, mouth, throat (pharynx), larynx and vocal cords and nasal cavity.

Head and neck cancer represent the sixth most common cancer in men and the eighth most common in women. Despite this, and even considering that the mouth is an easily accessible organ, this type of cancer is not well known by the general population when compared to other tumours.

The main risk factors are: i) chronic consumption of tobacco and alcohol, particularly if associated with ii) HPV infection (Human Papillomavirus) – more recently.

As with all tumours, an early diagnosis and prompt, adequate treatment are essential for the prognosis. But treating head and neck tumours is as important as minimising its sequelae. Since the region is host to functions as basic as speaking, eating, breathing and smiling, both the tumour and treatment can cause huge limitations for the patient.

Another issue that arises is the fact that it is a usually exposed region of the body, also causing aesthetic sequelae, which can bring inhibition and insecurity.

Diseases of the salivary glands (parotid, submaxillary, sublingual): inflammations, calculi and tumours
Inflammatory diseases of the salivary glands, also called sialoadenitis, usually cause pain and swelling of the glands when saliva is produced and cannot be expelled during meals. There are several causes for saliva not reaching the mouth, the most common being the presence of calculi (stones). It is also possible to have stones in the salivary glands; these are similar to having kidney stones.

Most salivary gland tumours are benign, but they should be removed surgically, since they grow over time causing aesthetic deformity for the patient, in addition to harbouring the risk of transformation and overtime becoming cancer.

Congenital diseases: branchial cysts, thyroglossal and dermoid cysts, lymphangiomas, hemangiomas
As the name suggests, these are diseases that we were born with and, as such, they manifest themselves more frequently in childhood, although in some cases they are only diagnosed in adulthood. They are usually benign but require surgery for a definitive resolution and to avoid complications.

Thyroid and parathyroid
They are the endocrine organs of the neck where nodules usually appear. Most of them are benign, but the nature of some of these nodules needs to be clarified and surgically removed.

Investigation of masses/nodules in the neck
Most diseases of the head and neck, and even several other diseases of the rest of the body, can manifest themselves through masses or nodules in the neck.
The assessment of these masses can be quite complex due to the number and diversity of the diseases that may be the cause of the nodules, particularly when there are no other associated symptoms.

The approach is to search for the most probable diagnoses, either through endoscopic examination in an otorhinolaryngology consultation, or through complementary exams, to clarify the nature of the disease and a subsequent timely treatment.

By Dr. Carlos E. Nabuco, otorhinolaryngologist at the HPA Health Group – Gambelas