HMC in a ‘first of its kind’ head and neck surgery

By Noimot Olayiwola/Staff ReporterThe Head and Neck Section of the Hamad Medical Corporation’s Ortholaryngology  Ear, Nose and Throat ‘ORL-HNS (ENT)’ department has scored a first in the Arab region by successfully performing five major reconstructive head and neck cancer resection using microvascular anastomosis surgery.The patients included those who had cancer of the tongue, oropharynx and hypopharynx (like oral cancer and cancer of the larynx) and salivary gland tumours.Another European patient will be operated soon.“The microvascular anastomosis surgery is the removal of cancer with laser and reconstruction and resection of the patient’s neck with a tissue flap from their own arm. We have been able to conduct five of such operations since January this year…we consider this a major success,” ORL-HNS (ENT) senior consultant Dr Zeynel Abidin Dogan, who led the HNS team that performed the surgery said.The team comprised one resident doctor, two ENT consultants and three ENT specialists.He pointed out that the five cases done so far this year is high compared to what he used to experience while in Germany.“I found this five cases many already because in Germany where I was practicing before joining HMC, we hardly see up to five cases a year,” he said without elaborating whether the prevalence of head and neck cancer is high in Qatar.Meanwhile, according to the National Cancer Strategy, the number of all cancer cases is expected to rise as population rises in Qatar and head and neck cancer could form up to a quarter or one third of all cancer cases in the country. “Head and neck cancer can be cause by a number of risk factors such as smoking, heavy use of alcohol, chewing of some bitter nuts (now very common practice) and the new human papilloma virus (HPV), this is especially common among young people,” Dr Dogan said.Symptoms could include swelling or sore that does not heal; red or white patch in the mouth; lump, bump, or mass in the head or neck area (with or without pain); persistent sore throat; foul mouth odour not explained by hygiene, hoarseness or change in voice; nasal obstruction or persistent nasal congestion; frequent nose bleeds and/or unusual nasal discharge; difficulty breathing; double vision; numbness or weakness of a body part in the head and neck region; pain or difficulty chewing, swallowing, or moving the jaws or tongue; ear and/or jaw pain; blood in the saliva or phlegm (mucus discharged in mouth from respiratory passages); loosening of teeth; dentures that no longer fit; unexplained weight loss and fatigue.The doctor maintained that radiotherapy and chemotherapy radiation are the first two modalities for combating head and neck cancer stating that  both treatments have highest rate of success.“Conducting surgery depends on the malignancy of the tumour and when it was not yet available, patients were being treatment with either radiotherapy or chemotherapy and both could be administered in more advanced cases,” he explained.“Surgery is much more difficult as an operation procedure can last 6-10 hours and two teams are usually simultaneously involved in the operation – the head and neck and arm surgical teams,” ENT consultant Dr Faisal Issam Abdulkader explained.The Head and Neck Section currently runs eight clinics per week at the Hamad General Hospital’s out-patients department looking after patients who suffer from cancer of the head and neck.“The quality and good service that we offer at the section is convincing enough to make more people stay back to avail our services and our aim is to prevent many more patients from travelling abroad for similar surgeries,” Dr Abdulkader said.He said that the department has achieved the milestone of seeing patients within 48hrs after referrals as stipulated in the cancer strategy.Other team members are ORL-HNS (ENT) specialists Dr Hussein al-Enazi, Dr Waheed Rahmon S Khan and Dr Salahideen Gazi.