Head and Neck Oncology Unit

Head and Neck Oncology Unit at Ars Medica Clinic

A Cutting-Edge Center for the Treatment of Head and Neck Cancers

Located in the heart of Rome North, Ars Medica Clinic stands as a premier healthcare institution, increasingly recognized as a leading oncology center for the prevention, diagnosis, and treatment of oral cavity, throat, and head and neck tumors. Despite their rarity and limited media attention, these malignancies pose a significant social and medical challenge due to the complexity of treatment, anatomical and functional consequences, and their profound impact on patients’ quality of life.

At the Head and Neck Oncology Unit, patients receive comprehensive, personalized care through an integrated, multidisciplinary approach, ensuring seamless management from diagnosis to treatment, rehabilitation, and follow-up. Each patient is entrusted to a dedicated specialist who coordinates their entire care journey with the full support of an expert medical team.

What Types of Tumors Are Treated at the Head and Neck Oncology Unit?

Head and neck cancers account for 6-7% of all malignant tumors worldwide, with the oral cavity being the most common site (42%), followed by the pharynx and larynx. In Italy, over 110,000 people are affected, and in 2022 alone, 9,750 new cases were diagnosed, with 3,800 deaths reported (AIOM, 2023).

While the majority of cases involve squamous cell carcinoma of the upper aerodigestive tract, our unit also specializes in treating:

• Salivary gland tumors (parotid, submandibular, sublingual)
• Thyroid and parathyroid tumors
• Non-melanoma skin cancers
• Vascular tumors (paragangliomas, carotid body tumors)
• Neurofibromas (schwannomas)
• Lymphomas
• Rare odontogenic tumors (ameloblastomas and others affecting the jaw and maxilla)
• Bone and soft tissue sarcomas
• A Focus on HPV-Related Tumors

Special attention is given to human papillomavirus (HPV)-related cancers, particularly those affecting the oropharynx (the base of the tongue, tonsils, and throat). These HPV-positive cancers are increasingly common among young, healthy males without a history of tobacco or alcohol abuse. With 45,000 new cases annually, projections suggest an incidence of 10.5 cases per 100,000 people by 2030.

What Services Does the Head and Neck Oncology Center Offer?

Our multidisciplinary team comprises highly specialized surgeons, oncologists, speech therapists, dietitians, psycho-oncologists, and nurses, providing state-of-the-art care for both hospitalized and outpatient patients.

 

Our Services Include:

• Comprehensive clinical evaluations
• Advanced diagnostic imaging
• Surgical treatment strategies, including:
• Otolaryngology and cervico-maxillofacial surgery
• Conservative laser and minimally invasive techniques
• Reconstructive surgery following radical procedures
• Extreme surgery with immediate reconstructive interventions
• Non-surgical therapies, such as:
• Radiotherapy (including IMRT)
• Chemotherapy, biotherapy, and immunotherapy
• Specialized anesthesia, intensive care, and pain management services
• Access to cutting-edge, fully digitalized operating rooms

Why Choose the Head and Neck Oncology Unit at Ars Medica?

Our unit guarantees a multidisciplinary and highly specialized approach, where each expert collaborates to develop tailored diagnostic, therapeutic, and rehabilitative strategies.

By combining medical excellence with advanced technology, we place the patient at the center of care, ensuring precise, integrated, and personalized treatments for optimal outcomes.

Pioneering Diagnosis and Early Detection

Recognizing early symptoms and diagnosing head and neck tumors at an initial stage offers a cure rate exceeding 90%. Our state-of-the-art oncology outpatient clinic is dedicated to early detection, providing:

• Comprehensive medical evaluations
• Thorough examination of the oral cavity, oropharynx, nasal passages, nasopharynx, hypopharynx, larynx, skin, and cervical region
• Advanced Diagnostic Techniques
• High-definition endoscopy: Using rigid or flexible endoscopes connected to a high-resolution monitor and recording system
• Videoendoscopy with magnification (Bioendoscopy): An innovative imaging system that detects precancerous lesions not visible through traditional endoscopy
• Biopsy and Molecular Pathology:
• Microscopic analysis of tumor tissue
• Molecular characterization (HPV, EBV, PD-L1, and other biomarkers)
• Crucial for treatment planning and personalized medicine

Advanced imaging:

• Ultrasound, CT, MRI with contrast, and PET/CT scans to assess tumor spread and guide treatment decisions
• Excellence in Cervico-Maxillofacial Oncologic Surgery
• Whenever possible, surgical intervention or radiotherapy (with or without chemotherapy) remains the preferred treatment for head and neck tumors. However, 90% of cases are diagnosed at an advanced stage, often necessitating radical and invasive surgeries.

Minimally Invasive and Conservative Surgery

For early-stage tumors, organ-preserving surgery is prioritized, employing:

• Minimally invasive techniques with or without laser surgery
• Scarless approaches
• Reduced operating time, shorter hospitalization, and faster recovery
• A cure rate exceeding 90%

When conservative techniques are not feasible, standard surgical approaches are performed with the utmost precision to minimize functional and aesthetic impairments, utilizing:

Magnification systems

Intraoperative monitoring for enhanced precision

State-of-the-Art Reconstructive Oncology Surgery

“Top-Tier” Microvascular Free Flap Surgery

The Head and Neck Oncology Unit at Ars Medica is distinguished for its expertise in complex reconstructive surgeries, particularly for locally advanced and recurrent tumors requiring highly specialized, extreme surgical interventions.

We excel in composite, multi-tissue reconstruction, using:

• Microvascular free flaps (perforator and non-perforator flaps)
• Single or multiple tissue transfers
• Highly specialized vascular microsurgery techniques—performed at only a handful of centers nationwide

Expert Surgical Team

Our reconstructive program is led by:

• Prof. Giovanni Almadori (Head and Neck Oncologic Surgery)
• Prof. Marzia Salgarello (Reconstructive and Aesthetic Plastic Surgery)

Both surgeons are renowned international authorities in their fields, having performed over 700 combined reconstructive procedures at the Policlinico Universitario Agostino Gemelli IRCSS Rome since 2002, and now at Ars Medica.

By utilizing patient-derived tissue (skin, muscle, bone) and performing precise microvascular anastomoses, we achieve optimal anatomical, functional, and aesthetic restoration, ensuring:

• Radical cancer removal
• Superior oncologic and cosmetic outcomes
• Enhanced quality of life

This approach represents the pinnacle of oncoplastic surgery, delivering exceptional therapeutic and aesthetic results.

Salvage Surgery with Palliative Intent

Microvascular free flaps—whether perforator or non-perforator, single or multiple—have significantly improved oncologic and functional outcomes in palliative surgery, which is increasingly sought after to enhance end-of-life care for both patients and their families. Furthermore, this approach does not preclude the possibility of additional adjuvant therapies, including chemotherapy, re-irradiation, targeted therapy (biotherapy), and immunotherapy (combined treatment strategies).

Regenerative Surgery with Stem Cells

The Head and Neck Oncology Unit also offers innovative regenerative surgery utilizing stem cells derived from autologous adipose tissue (lipotransfer). This technique is used to treat scarring of the skin and mucosa following radiotherapy or surgery, leading to functional, anatomical, and aesthetic improvements for the patient.

This lipofilling procedure is also employed to enhance voice quality in dysphonic patients suffering from scarring due to oncologic or functional surgery on the vocal cords, or laryngeal paralysis following surgery on the thyroid, neck, or upper mediastinum.

Vocal cord lipofilling is a minimally invasive procedure that can be performed under:

• General anesthesia via transoral microlaryngoscopy
• Local anesthesia via endoscopic techniques (using flexible videoendoscopes with an operative channel)

Rehabilitation and Support Services

The Phoniatrics and Speech Therapy Service at Ars Medica Clinic provides specialized speech therapists and rehabilitation tools for patients with swallowing and voice disorders following conservative surgery or radiotherapy. It also supports patients who have undergone total laryngectomy with voice prosthesis placement.

Diagnostic Techniques Utilized:

• Videoendoscopy
• Videolaryngostroboscopy
• Acoustic voice analysis
• Dynamic endoscopic swallowing study (FEES)
• Videofluoroscopy (VFS)
• Exclusive oropharyngeal-esophageal transit scintigraphy (OPES)

Additionally, a Physiotherapy Service is available for movement disorder rehabilitation, along with a Psycho-Oncology Service that provides emotional support to oncology patients and their families. This service also includes a therapeutic program for tobacco and alcohol addiction, utilizing integrated psychotherapy and hypnosis.

Screening and Prevention Programs

Ars Medica Clinic organizes free screening days for the early diagnosis of Head and Neck Cancers, targeting men and women over 40 and high-risk individuals (smokers, habitual drinkers, and those with a family history).

These screenings include:

• A specialist ENT examination
• Comprehensive exploration of the oral cavity, oropharynx, nasal passages, nasopharynx, pharynx, and larynx using high-resolution videoendoscopy with magnification (bioendoscopy)

This cutting-edge technology enhances lesion detection accuracy, reduces the need for histological biopsy sampling, and allows for the longitudinal monitoring of targeted lesions.

Screening for HPV-Positive Tumors

This screening program is especially crucial for younger individuals, particularly unvaccinated males aged 13-19, who are at higher risk of human papillomavirus (HPV)-related tumors.

• Oral HPV test (“oral Pap test”): A painless, simple screening method that involves a swab of the palatine tonsils and the base of the tongue to detect low- or high-risk HPV infections.
• Cytobrush sampling: A new, non-invasive cytological collection tool for the oropharynx, which does not require local anesthesia and achieves up to 90% diagnostic concordance with traditional histological biopsy.
• This method provides high diagnostic accuracy with minimal patient discomfort, facilitating early diagnosis, prevention, and potential “preventive surgery” (tonsillectomy).

Awareness Campaigns and Informational Materials

Ars Medica Clinic actively promotes public awareness initiatives on Head and Neck Cancers by organizing numerous educational events and distributing informative brochures.

The clinic participates annually in:

• Head and Neck Cancer Early Diagnosis Week (September 16-21) as part of the Make Sense Campaign, supported by the Italian Association of Head and Neck Oncology (AIOCC) and the European Head and Neck Society (EHNS).
• World Head and Neck Cancer Day (July 27), raising awareness on the importance of early detection and prevention.