Head and Neck Surgery Division

Introduction

Surgical treatment for head and neck cancer demands the fulfillment of 2 contradictory requirements: (1) the area of resection must be however, it should be small enough to preserve important functions such as swallowing, speech,vision, and cosmetic appearance. The Head and Neck Surgery Division resolves these conflicting requirements mainly via 2 distinct approaches:conservative surgery and extensive resection with microsurgical reconstruction. Conservative surgery has been the most successful for voice preservation and includes vertical partial laryngectomy that is indicated for T1/T2 glottic carcinoma, recurrent glottic carcinoma after radiotherapy, and some cases of early false cord carcinoma. Laryngeal preservation is also possible in T1/T2 hypopharyngeal carcinoma with limited extension. The other approach, i.e., extensive resection with microsurgical reconstruction, is designed to minimize loss of function occurring after ablative surgery by employing microsurgical transfer of various flaps. Please consult the annual report of the Plastic Surgery Division for further details.

Routine Activities

Multimodal therapy forms the core of the current treatment policies for head and neck cancer. In order to effectively implement these therapeutic modalities, 5 staff surgeons at this Division work consistently with plastic surgeons, radiotherapists, medical oncologists, dentists, psycho-oncologists, nurses, and other hospital staff. Several weekly conferences are conducted to facilitate constant communication among the members of this large team.
In 2007, 414 new patients were treated at this Division. Owing to the recent advances in surgical techniques and perioperative care, the number of surgically treated high-risk patients, including elderly patients aged >80 years, is increasing. Technically difficult operations, such as surgical resection of advanced oropharyngeal carcinoma with immediate reconstruction, are also increasingly performed.

● M. Saikawa ●

Number of surgeries performed in patients under general anesthesia during 2003_2007
2003 2004 2005 2006 2007
595 505 415 519 501

Number of new cancer patients admitted during 2003-2007
Primary Cancer Site 2003 2004 2005 2006 2007
Tongue 71 65 60 33 58
Oral cavity, excluding the tongue 59 72 57 58 55
Larynx 67 60 50 36 80
Nasopharynx 18 18 15 13 13
Oropharynx 35 45 35 39 40
Hypopharynx and cervical esophagus 81 80 63 64 87
Nasal cavity and paranasal sinuses 25 23 16 24 21
Thyroid gland 53 61 46 35 41
Major salivary glands 17 21 7 10 9
Others 20 21 24 16 10
Total 446 466 373 328 414

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