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Head and neck cancer represent nearly 12% of total malignancies, including the face, the oropharynx, the parotid gland and other salivary glands, the orbit, the jaw , the sinuses and other parts of the face including the skin. These anatomical sites might be affected by other varieties of cancer, such as basal cell carcinoma, squamous-cell carcinoma, fibro sarcoma, osteogenic sarcoma and jaw lymphoma, and non-Hodgkin’s lymphoma and Hodgkin’s lymphoma. Jaw lymphoma is nominated from other parts of the world and Africa, such as Burkitt lymphoma. Jaw lymphoma is quite different from Burkitt lymphoma in its clinical features, aetiology and even with regard to its treatment. Jaw lymphoma is presented as having a very rapid onset with a fast spread to internal organs and the brain, while Burkitt lymphoma is a slowly growing tumour; it is well known that Burkitt lymphoma can be treated successfully by a few courses of cyclophosphamide (40 mg/square meter) but jaw lymphoma requires a more complicated regimen with combination of many chemotherapeutic agents, such as CHOP( therapeutic regimen of jaw lymphoma consist of eight doses over 24 weeks including 1.5mg/m2 Vincristine,50mg/m2 Adriamycin, 1000mg/m2 Cyclophosphomide, 10mg/m2 Methotroxate and 50mg/m2 prednisolone ) and it rarely deposits its tumour to the lymph nodes. Cancer of the head and neck constitute an important section of the total cancers affecting the body, and oral cancer represents about 4% of this; it is not necessary that all such cancers have nodal deposits in the neck, such jaw lymphoma or Burkitt Lymphoma. Malignant tumours such as squamous cell carcinoma – which form about 95% of oral cancers – and Melanoma – a highly malignant tumour with early metastasis – are rare and aggressive types of tumours and the survival rate is very low. Other malignant tumours, such as adenocarcinoma – which is a slowly growing malignant tumour – have less of a tendency for cervical node metastasis. Cancer of the paranasal sinuses is considered to be an aggressive type of malignancy with a tendency to invade the orbit and the base of the skull. The most common tumour of the sinuses is squamous cell carcinoma rather than adenocarcinoma, as a result of cellular changes from respiratory columnar type to squamous type due to the recurrence of infection and other irritating agents. These types of tumour metastasise in the cervical lymph nodes. Cancer of the oral cavity represents somewhat less than 4% of total cancer incidence but this might increase to more than 40% – as in India due to dietary causes such as spicy foods and

Head and Neck Cancer and Neck Dissection - A Personal View