Skip to content

Mouth, throat, voice box & neck

Head & Neck Oncologic Surgery

A lump in the neck, a mouth ulcer that won't heal or a voice that stays hoarse can be worrying. Here's how these problems are investigated, what treatment involves and the support you'll have afterwards.

Illustrative image: Flexible nasendoscope used to examine the throat and voice box, beside a glass of water in a consulting roomIllustrative image

After partial or total glossectomy for oral malignancy, rehabilitation is coordinated with allied speech and language therapists. Dr Kana's academic interest includes the development of a tongue-strength measurement device, intended to support measurable functional rehabilitation.

A multidisciplinary approach

Treatment for head and neck cancer is planned in a multidisciplinary setting. Surgical, radiation and medical oncology opinions are considered together with pathology and radiology findings, so that each patient receives a treatment recommendation based on the stage and site of the disease.

Treatment goals include complete removal of the cancer together with preservation of speech, swallowing, breathing and appearance wherever this is clinically possible.

Oral cavity and tongue

Cancers of the tongue and floor of mouth are commonly treated with surgical resection, with or without neck dissection. Depending on the size of the defect, reconstruction may involve local tissue or a free tissue transfer performed with reconstructive colleagues.

Getting back to clear speech and safe swallowing after tongue surgery is a central part of the plan. Speech and language therapy starts before the operation, not after it.

Salivary gland tumours

Most parotid gland tumours are benign, but surgical removal is often recommended to establish a definitive diagnosis and prevent growth. The facial nerve passes through the parotid gland; its identification and preservation is a primary consideration during parotidectomy.

Larynx and neck

Persistent hoarseness, a neck lump lasting longer than three weeks, difficulty swallowing or unexplained ear pain in an adult warrants specialist assessment. Investigation typically includes flexible endoscopy, cross-sectional imaging and tissue diagnosis.

Treatments in this area

  • Partial and total glossectomy
  • Parotidectomy with facial nerve preservation
  • Submandibular gland excision
  • Total laryngectomy
  • Selective, modified radical and radical neck dissection
  • Thyroidectomy for carcinoma

Your care team may include: ENT and head & neck surgery, Radiation and medical oncology, Speech and language therapy, Dietetics, Reconstructive surgery where indicated.

For referring doctors

When to refer, and what to send

Send a secure referral

Referral criteria

  • Non-healing oral ulcer or mass persisting beyond three weeks
  • Neck mass in an adult persisting beyond three weeks, particularly with risk factors
  • Persistent hoarseness beyond three weeks in a smoker or adult over 45
  • Parotid or submandibular mass
  • Histologically confirmed head and neck malignancy requiring surgical opinion

Helpful work-up before consultation

  • Contrast-enhanced CT or MRI of the head and neck (DICOM)
  • Histology or cytology reports, including referring laboratory details
  • Chest imaging where available
  • Summary of relevant comorbidities and current medication

Common questions

Things people often ask

Can't see your question here? The rooms are happy to help.

Contact the rooms
Will I be able to speak and swallow after tongue surgery?

Outcomes depend on how much of the tongue is removed and whether reconstruction is required. Speech and language therapy begins before surgery and continues afterwards. Your expected functional outcome is discussed with you during consultation.

Is a neck dissection always necessary?

Not always. The decision is based on the site, size and depth of the primary tumour and imaging of the neck lymph nodes. This forms part of the multidisciplinary treatment plan.

Is speech therapy part of recovery after tongue surgery?

Yes. Speech and language therapy is arranged with allied therapists before and after surgery. How much therapy is needed depends on the surgery and on your own recovery.

Travelling from outside South Africa?

Medically reviewed by Dr Nadir Kana, Otorhinolaryngology (ENT) and Head & Neck Surgery. Last reviewed .