ENT AND SALIVARY GLAND CANCERS
A multidisciplinary team provides diagnosis, treatment, research and teaching. This team includes surgeons from Lacassagne and the University Hospital of Nice, grouped together in the University Institute of Face and Neck.
Mucous cancers (squamous cell carcinoma) account for the majority of these tumors. Their locations in the oral cavity, oropharynx, nasopharynx, hypopharynx and larynx, are fully managed.
Cancers of nasal and sinus cavities are managed in close collaboration with the ENT General department (Pr Laurent Castillo).
Tumor pathology of the neck is also managed by this sector, be it tumors of congenital origin (branchial cysts), of vascular or nerve origin (shwannomas, paragangliomas) or lymph node (metastases of unknown origin, lymphomas ).
VADS CANCERS ARE THREATED WITH 3 THERAPEUTIC METHODS, IN COMBINATION OR INDIVIDUALLY:
- Surgery: this usually involves removal of the primary tumor and cervical drainage lymph nodes (cervical dissection). Tumor excision surgery can be performed externally or endoscopically using CO2 Laser. This surgery is usually accompanied by more or less complex reconstruction surgery (pedicled flaps, free flaps, etc.).
- Radiotherapy: this can be performed immediately or postoperatively. It requires precise definition of volumes processed and saved. Currently, it benefits from new irradiation techniques (conformal radiotherapy with intensity modulation) which preserves healthy tissue and reduces long-term sequelae. CyberKnife® can be used for initial irradiation or re-irradiation of some specific ENT tumors.
- Chemotherapy: it can be offered at different stages of treatment, whether in induction before any treatment, in combination with radiotherapy postoperatively or from the outset, or before recurrent tumor or metastatic stage. It can include association of several molecules and currently benefits from new therapeutic agents with precise action on a well-defined biological target (targeted molecular therapy).
The University Institute of the Face and Neck developed, early on, complex reconstruction techniques (microsurgery, free flaps) in ENT cancer surgery enabling removal of very advanced tumors while drastically decreasing operative complications as well as functional and aesthetic sequelae.
Preoperative Virtual Modeling (PVM) for maxillary reconstruction of oral cancers
This technology has been developed for ENT cancers requiring mandibular repair by free vascularized bone graft.
Loss of bone substance can be anticipated by using a 3D computer model, in order to shape and ultimately manufacture the bone transplant.
Between 50 and 60 patients per year benefit from this reconstructive surgery by micro-anastomosing transplant or “free transplant” at Antoine Lacassagne Center; about 15 to 20 of them involve reconstruction of the jaw by fibula transplant.
This reduces functional sequelae, especially in the case of mandibular symphysis (chin) amputation.
These complex surgical techniques enable an effective response to regional needs in this area and to train future ENT surgeons in this state-of-the-art surgery.
ONCOLOGICAL SURGICAL POLE CERVICO-FACIAL
Dr Olivier Dassonville
Pr Alexandre Bozec
Dr Gilles Poissonnet
Dr Dorian Culié
DEPARTMENT OF MEDICAL ONCOLOGY
Pr Joël Guigay
Dr Christophe Hebert
Pr Frédéric Peyrade
Dr Esma Saada-Bouzid
Dr Véronique Mari (Onco-genetics)
Dr Danielle Benisvy
Pr Jacques Darcourt
Dr Déborah Aloi
Dr Médéric Barret