Head and Neck Cancer

The Head and Neck Cancer Center at the University of Nebraska Medical Center is a multidisciplinary effort including head and neck surgical oncology, plastic and reconstructive surgery, medical oncology, radiation oncology, speech therapy, pathology and support staff to provide comprehensive care to patients afflicted with cancer involving the head and neck.

Head & Neck image
The Head and Neck Cancer Center's efforts are directed by Head and Neck Surgical Oncologists, Daniel Lydiatt, DDS, MD and William Lydiatt, MD.

The Head and Neck Service within the department of Otolaryngology-Head and Neck Surgery at the University of Nebraska specializes in the care of patients with benign and malignant tumors of the mouth, throat, voice box (larynx), salivary glands (parotid, submandibular, and minor), sinuses, thyroid and parathyroid glands, lymph nodes, ear, nose and skin of the head and neck. We utilize the expertise of many subspecialists including plastic and reconstructive surgeons Drs. Hollins and Johnson, dental oncologists and prosthodontists Drs. Mahanna and Sheridan, speech and swallowing specialists Marsha Sullivan and Carol Gabler, and prosthetic artist Cydette Iwamoto. Each new patient is anonymously discussed at a weekly head and neck tumor conference on Monday morning. Experts from radiation therapy, medical oncology, pathology, radiology, dental oncology, plastic and reconstructive surgery, and head and neck surgery provide input to formulate a plan for each individual.

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Signs and Symptoms of head and neck tumors

Mouth, throat and sinuses

The most common malignancy of the head and neck is squamous cell carcinoma. Most cases 85-90% are related to tobacco use. Alcohol may also work as a promoter. Small tumors have an 80-95% cure rate using either surgery or radiation therapy. Larger tumors require more extensive treatment but cure is still possible. Early diagnosis is important in achieving excellent cure rates. Symptoms which are suggestive of tumor include sores that do not heal after approximately 2 weeks, sores that wax and wane in size or intensity, ear pain, persistent cough or sore throat, recurrent bleeding from the nose, nasal obstruction on one side, or decreased hearing in one ear. Other symptoms include pain or difficulty swallowing, hoarseness or a change in voice. A neck mass which is increasing in size or has been present for more than two weeks should also be evaluated. If these are present you should see your physician or contact us with questions.

Thyroid tumors

Most tumors of the thyroid present as a growth in the lower midline of the neck. These may cause difficulty swallowing or hoarseness but usually are found in routine examinations by physicians or patients themselves. A history of exposure to radiation or a family history of thyroid cancer are known risk factors. Tumors of the thyroid are much more common in women. Most tumors are benign. Even if a malignant tumor of the thyroid is found, survival is excellent in most cases. Diagnosis of the tumor usually involves a small needle inserted into the mass in the doctors office. Treatment generally involves surgical removal of part or all of the thyroid gland.

Salivary Gland tumors

The salivary glands produce saliva to aid in chewing and digestion. The largest salivary gland is the parotid. People have two parotid glands which are found in front of and below the ears. Most tumors of this gland are benign (80%) but need to be removed because they will continue to grow causing cosmetic and functional problems. Malignant tumors will eventually prove lethal if not treated. Surgical removal of the parotid gland is generally curative. Salivary gland tumors can also be found in the submandibular glands underneath the jaw bone. Tumors in this area are more likely to be malignant (50%) than in the parotid. Surgical resection possibly with radiation is most often the treatment of choice.

Facial Prosthetics and Dental Oncology

Research Opportunities

The head and neck service is actively involved in research to improve our patients life and cure of disease. We are investigating ways to prevent cancer of the mouth, and throat using aspirin. By studying a subgroup of people with a pre-cancerous lesion called leukoplakia we hope to use aspirin in the prevention of second cancers in our patients in whom the initial cancer has been treated. Prevention of additional cancers will ultimately improve cure rates and quality of life dramatically.

Once a cancer has developed we are looking into methods to improve cure rates and decrease the risk of treatment using monoclonal antibodies tagged with a radioactive isotope. We are in the third phase of a study whether this or similar antibodies will decrease the need for radiation therapy. These studies are in the early stages at this time but are very promising.

We are also investigating quality of life issues with respect to reconstruction of head and neck defects. Ongoing studies have shown that the use of the leg bone called the fibula is a cost effective, safe, and functional method of rebuilding the jaw when it has to be removed because of tumor. The fibula is the thin bone of the lower leg which is not necessary for walking. It is plated into place in the jaw and its blood vessels are sewn into vessels in the neck giving it a healthy blood supply which makes it more resistant to infection or the effects of radiation.

We are performing a product evaluation of OraKote which is an Aloe Vera preparation used to help treat sores in the mouth and throat that develop during radiation treatment. We will soon be participating in a trial for a new antibiotic which may help prevent esophagitis. this will be used on head and neck cancer patients who will be receiving radiation therapy.

Daniel D. Lydiatt, MD
Associate Professor
Dental Degree: University of Nebraska
Medical School: University of Nebraska
Master of Science Anatomy/Surgery: University Nebraska
Oral and Maxillofacial Surgery Residency: University of Nebraska
Otolaryngology-Head and Neck Surgery Residency: University of Nebraska
Head Neck Surgical Oncology Fellowship: M.D. Anderson Cancer Center, University of Texas
Board Certifications:
  • Oral and Maxillofacial Surgery
  • Otolaryngology-Head and Neck Surgery
  • Fellowship Certification:
  • Head and Neck Surgical Oncology
William Lydiatt, MD
Assistant Professor
Medical School: University of Nebraska
Otolaryngology-Head and Neck Surgery Residency: University of Nebraska
Head and Neck Surgical Oncology Fellowship: Memorial Sloan Kettering Cancer Center, Cornell University
Board Certifications:
  • Otolaryngology-Head and Neck Surgery
  • Fellowship Certification:
  • Head and Neck Surgical Oncology
  • Cancer of the Head and Neck