The Head and Neck Oncology Service at Amrita Hospital has always strived to be a model for comprehensive multidisciplinary care in the country. The infrastructure, clinical services offered and the outcomes of patient care are on par with the best centers in the world. Head and neck cancers comprise of tumors of mouth, throat, voice box (larynx) and the associated structures such as sinuses, salivary and thyroid gland. It is now clearly established that multimodality treatment with surgery, radiation therapy and chemotherapyalone or in various combinations offer the best chance to cure the disease and to improve the quality of life of patients. Because of the involvement of multiple specialties, the treatment decision and monitoring is best carried out through a multidisciplinary head and neck oncology team, rather than by a single physician or a specialty. The team comprises of the head and neck surgical oncologist, radiation and medical oncologists, radiologist, pathologist, medical social worker and supportive care specialists. Our weekly tumor board consisting of these experts oversees the planning and care of all head and neck cancer patients. We also have dedicated tumour boards for thyroid and skull base disorders every month where in the treatment planning is done in great detail. All the treatment decisions are based on best current evidence and universally accepted treatment guidelines.
The surgical procedures offered are planned with a great focus placed on the functional and aesthetical recovery of the patients. Our planning is to ensure early return to the presurgical state. Microvascular reconstructive surgery forms a cornerstone in ensuring early return of form and function. The reconstructive surgery offered ranges from reconstruction of the tongue, cheek, jaw bone and even the food passage.
Laser surgery for early tongue and laryngeal cancers are available. This mode of treatment facilitates early healing.
Tumours of the nose and sinuses often present in advanced stages. The skull base services within the department uses the combined expertise of neurosurgery and head and neck surgery. For the sinus and skull base tumours, endoscopic and neuro-navigation assisted surgeries are available for precise tumour removal. Reconstruction is essential following complex resections of the face and skull base. This is offered to patients undergoing such surgeries in our department.
Thyroid tumours can present as small swellings or large invasive tumours in advanced stages. The treatment offered in our department combines the expertise of head and neck surgery, medical endocrinology and nuclear medicine. In certain advanced cases, the surgery should address the airway and the food passage. Such tumours are managed in our department. For a narrow airway, widening of the air passage by stenting is possible by our Radiology colleagues.
Salivary gland swellings can be both cancerous and non-cancerous. The treatment is usually surgery followed by radiation in selected cancer cases. Tumours of the parotid salivary gland sometimes can involve the facial nerve which is essential for functioning of the facial muscles. Repair and reconstruction of the facial nerve function is routinely offered to such patients. Stone formation is common within the gland and the ducts. For selected patients, non invasive endoscopic (sialendoscopy) removal is offered.
Dental rehabilitation in form of dentures and implants are also offered for patients after tumour removal. Prosthetic implants are planned and fabricated by our prosthodontic colleagues for defects of the face, ear and eye socket. The dental oncology service within the department takes part in the pre radiotherapy dental treatments and offer advice on dental care during radiation.
Sufficient rehabilitation of the patient with respect to speech and swallowing is required after extensive surgery to remove tumour. We have a dedicated speech and swallowing service which participates in the early rehabilitation of speech and swallowing function of our patients. These patients include both those who have undergone surgery and those who have received radiation treatment. Endoscopic and fluoroscopic evaluation precisely identifies the problem in these patients which can thereafter be corrected by rehabilitative techniques.
Non cancerous swellings of the head and neck including congenital swellings, vascular malformations, neurogenic tumours amongst others are also routinely managed by the department. The department has a state of the art operation theatre complex and a dedicated 12-bedded ICU for round the clock monitoring of post operative patients.