CHONC key terms

A rare, aggressive malignancy arising from melanocytes in the sinonasal or oral mucosa, often presenting without pigment and with a high rate of local recurrence and distant spread.

Tumor growth along or around small nerves, seen on histology, that predicts increased risk of local recurrence and spread along nerve pathways toward the skull base.

Radiologic or clinical extension of tumor along named cranial nerves away from the primary site, often requiring wider treatment fields and altering surgical planning.

The concept that chronic carcinogen exposure, such as tobacco and alcohol, leaves broad upper aerodigestive mucosa genetically altered, raising the risk of multiple synchronous and metachronous primary tumors.

The most common head and neck malignancy, arising from stratified squamous epithelium of the oral cavity, pharynx, and larynx, strongly linked to tobacco, alcohol, and human papillomavirus.

Testing of oropharyngeal tumors for HPV association, usually by p16 immunohistochemistry, which identifies a distinct entity with better prognosis and its own staging system.

The standardized system describing tumor size and invasion (T), regional nodal involvement (N), and distant metastasis (M) to guide prognosis and treatment selection.

Spread of metastatic tumor beyond the lymph node capsule into surrounding tissue, a poor prognostic finding that upstages nodal disease and often prompts adjuvant chemoradiation.

A staging procedure in which the first draining node is identified with tracer and removed for pathology, used to assess occult nodal disease in clinically node-negative oral cavity cancer.

Surgical removal of cervical lymph node levels at risk of harboring microscopic metastasis despite no clinical evidence of disease, performed to stage and control the neck.

Removal of cervical lymph node levels I through V while preserving at least one nonlymphatic structure, such as the spinal accessory nerve, internal jugular vein, or sternocleidomastoid muscle.

The eleventh cranial nerve, supplying the trapezius and sternocleidomastoid muscles, whose injury during neck dissection causes shoulder droop and limited arm abduction.

Transfer of tissue with its own blood supply from a donor site to a head and neck defect, with microvascular reconnection of vessels to restore form and function.

Bone death in previously irradiated tissue, most often the mandible, presenting with exposed bone that fails to heal, often triggered by dental extraction or infection.

Dental assessment and treatment of infection or nonrestorable teeth before radiotherapy begins, reducing the risk of osteoradionecrosis and treatment interruption.

Dry mouth from reduced salivary flow, commonly caused by radiation to the salivary glands, leading to dental decay, dysphagia, and impaired taste and speech.

An external beam technique that shapes and modulates radiation dose across many small beams, allowing high dose to the target while sparing nearby critical structures.

Postoperative radiation given together with a radiosensitizing drug, typically for high-risk features such as positive margins or extranodal extension, to reduce recurrence.

Delivery of chemotherapy at the same time as radiation, using drug radiosensitization to improve local control, most often for locally advanced disease or organ preservation.

A treatment strategy using radiation with or without chemotherapy to cure laryngeal or other cancers while avoiding surgical removal of the organ and its functional loss.

Surgical removal of the entire larynx, separating the airway from the digestive tract and creating a permanent tracheostoma, used for advanced cancer or salvage.

Voice production after laryngectomy using a one-way valve placed between the trachea and esophagus, allowing pulmonary air to vibrate the pharyngoesophageal segment.

Creation of a surgical opening in the anterior trachea to secure an airway, used for obstruction, prolonged ventilation, or airway protection after major head and neck surgery.

Difficulty swallowing that may result from tumor, surgery, or radiation, requiring assessment and therapy to maintain nutrition and prevent aspiration.

Lung infection caused by inhaling oral or gastric contents, a serious risk when swallowing is impaired by tumor, treatment, or altered anatomy.

A clinician who evaluates and treats swallowing and communication disorders, providing rehabilitation after surgery, radiation, or laryngectomy.

Weakness or pain from injury to the spinal accessory nerve or trapezius after neck dissection, managed with physical therapy and activity modification.

A scheduled meeting of surgeons, radiation and medical oncologists, pathologists, radiologists, and allied staff who jointly review cases and agree on treatment recommendations.

A new malignancy arising in the upper aerodigestive tract after treatment of an index cancer, reflecting field cancerization and requiring lifelong surveillance.

A second, separate cancer diagnosed at the same time as the index tumor, often in the lung or esophagus, which changes staging and treatment planning.

The process of explaining diagnosis, treatment options, risks, benefits, and alternatives so a patient can voluntarily authorize care, documented before procedures.

A financial or personal interest that could bias clinical judgment or research, which must be disclosed and managed to preserve trust and integrity.

A committee that reviews and approves research involving human subjects to protect participants' rights, safety, and privacy before the study begins.

Evidence-based recommendations developed by professional bodies to standardize diagnostic and treatment decisions and reduce unwarranted variation in care.

A measurable indicator, such as time from diagnosis to surgery or negative margin rate, used to monitor and improve the safety and effectiveness of care.

A structured peer review meeting that examines complications and adverse outcomes to identify system failures and improve future patient care.