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Cutting-Edge Techniques for Treating Head and Neck Cancer

Head and Neck Tumor Center Among the First To Offer Both Transoral Robotic Surgery and Sialendoscopy

The Head and Neck Tumor Center at MUSC, one of the most comprehensive programs in the nation, evaluates 750 to 800 new patients with tumors of the head and neck annually. It provides comprehensive care to these patients, drawing on a multidisciplinary team of head and neck surgeons, radiation oncologists, medical oncologists, oral surgeons, maxillofacial prosthodontists, speech/ swallowing specialists, nutritionists, specially trained nurses, researchers, and social workers. Traditionally, access to such tumors has required large incisions to the head or neck, resulting in substantial recovery times, scarring, and potential loss of function. MUSC’s Head and Neck Tumor Center has been among the first in the nation to adopt minimally invasive options that can achieve the same goals with less risk and inconvenience to the patient.

In January 2010, Terry A. Day, M.D., Vice Chair and Director of the Division of Head and Neck Oncologic Surgery, began offering robotic surgery. Robotic surgery of the head and neck has since been performed on patients with tumors of the thyroid gland, oropharynx, and larynx. Access would have traditionally been secured via a large incision on the head or neck requiring splitting of the jawbone. In contrast, transoral robotic surgery gains access through the mouth: a robot equipped with a 3D camera is inserted and surgeons, seated at a console, guide its small, rotatable arms as they explore the oropharyngeal region to locate and remove any tumors. Recovery times are far shorter, and in many cases feeding and tracheostomy tubes are not required.

MUSC’s Head and Neck Tumor Center was also one of the first five U.S. centers to adopt sialendoscopy for patients with blocked salivary glands, including patients with thyroid cancer whose salivary glands were damaged by the radioiodine therapy routinely given after removal of the thyroid. Sialendoscopy clears salivary gland blockages without removing the gland using a series of specialized and video camera– equipped endoscopes, which are inserted into the salivary gland via one of the four ducts that empty into the mouth. The smallest specialized scope is inserted first for diagnostic purposes, and then larger scopes are placed, with working channels through which microinstruments (eg, small forceps, small hand drills, laser fibers) can be inserted. Of patients who undergo sialendoscopy, 95% achieve substantial improvement, with only 5% ultimately requiring gland removal. M. Boyd Gillespie, M.D., of the MUSC Head and Neck Tumor Center has performed more than 500 sialendoscopies, drawing patients from 21 states and territories.