What is Oropharynx?
The back of the mouth where it meets the throat is called the oropharynx (or o far inx). This region includes all of the soft palate, the tonsil region, and the back of the tongue where it goes out of view, extending down towards the voice box (larynx).
What kind of cancers occur in oropharynx?
Cancers in the oropharynx most commonly begin in the tonsil, soft palate or tonsil–like tissue of the tongue base. Malignant tumors here usually begin on the mucous membrane lining (these tumors are called called squamous cell carcinoma) but can also arise in white blood cells (lymphoma) or glandular cells (adenocarcinoma). Squamous cell carcinoma is the most common malignancy in this area.
What are the causes of oropharynx cancer?
Oropharyngeal cancer usually arises in individuals aged 45 – 70 who have abused tobacco and alcohol. The human papillomavirus has been found in over half of these tumors and probably plays a role in cancer development. This virus might be transmitted through sexual contact.
Early Signs and Symptoms Oropharynx Tumors
Early signs and symptoms of oropharynx tumors include development of asymmetrical tonsils, pain such as a persistent sore throat, particularly pain that shoots to one ear, difficulty or pain with swallowing, a muffled sound to the voice, or a lump in the neck.
Often your doctor can visualize tumors in this area without any special instruments, but may need special mirrors or fiberoptic telescopes. The doctor may also need to feel the back of the throat with a gloved finger. A biopsy is necessary to confirm a diagnosis. Although, often this area (tonsil and soft palate) can be biopsied by your Otolaryngologist-Head and Neck surgeon in the office with local anesthetic, sometimes biopsy is carried out with the patient under general anesthesia. For base of tongue, often biopsy requires general anesthesia.
What treatments are used for orophaynx cancers?
Treatment of oropharyngeal cancer often consists of surgery or radiation therapy with or without chemotherapy. Small tumors may be removed surgically without loss of throat function. Larger tumors can be removed surgically if necessary but these surgeries require reconstruction of the throat and may harm the ability to swallow.
Laser Microsurgery for Oropharynx Tumors
Newer, through the mouth, minimally invasive laser surgery can be employed for appropriately selected patients with oropharynx cancer with excellent swallowing function. With this type of surgery, usually no reconstruction is needed especially for tonsil and base of tongue area. Selected patients with soft palate tumor can have reconstruction, if needed, with transfer of adjacent tissue from mouth obviating need for a major reconstructive procedure. However, larger resections require major reconstruction. For early tumors surgical treatment may be all that is needed without need for radiation therapy. A major advantage of minimally invasive, organ and function preserving surgery when used alone is preservation of salivary function. This makes it easier to maintain oral and dental hygiene and function and helps prevention of dental decay often associated with radiotherapy.
It is anticipated that with radiation therapy significant amount of normal tissue including major salivary glands as well as minor salivary gland are in the field of radiation and hence subject to side effects of radiation. For salivary glands this includes atrophy, fibrosis (scarring) and significantly reduced saliva production with resultant permanent dry mouth.
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