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Glossary

A diagnosis of head and neck cancer can often mean an introduction to a new world of cancer-related phrases and terminology. The Head & Neck Cancer Guide's glossary will provide the definitions of terms related to head and neck cancer, its diagnosis and treatment.

A

Ablative Surgery

The surgical removal of diseased tissue.

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Adjuvant Therapy

Treatment used in addition to the main treatment, often referring to treatment after surgery to increase the chance of curing the disease or keeping it under control.

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Alaryngeal Speech

The act of speaking after the removal of the larynx, the anatomic structure that holds the vocal cords.

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Alopecia

Hair loss from the head or body. Alopecia can be a side effect from medication, such as chemotherapy.

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Andy Gump Deformity

Named after a character in an early 20th-century comic strip who had an altered facial profile due to a missing lower jawbone, or mandible. The character was likely modeled after a patient who had undergone an early surgery for head and neck cancer that involved the removal of the lower jaw. Not only did patients have a different facial profile as the result of such a surgery, but they also had problems with eating and drooling.

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Anemia

A condition in which a person’s blood has a lower than normal amount of hemoglobin, which is a protein in red blood cells that carries oxygen.

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Antiemetics

Medications used to control nausea and vomiting symptoms; nausea and vomiting are often a side effect associated with chemotherapy.

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Aphonia

Total loss of voice.

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Articulatory Imprecision

The inability to speak correctly, such as the pronunciation of consonants, can be caused by factors such as a change in the functioning or the range of movement of the muscles that are used for speaking.

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Auriculectomy

Surgical procedure to remove all or part of the ear.

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B

Barium Swallow

A test conducted to evaluate problems with swallowing. A patient ingests a mixture containing barium sulfate, then an X-ray is used to visualize the digestive tract. Smooth muscle relaxants may also be administered during conventional barium swallow tests.

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Benign Tumor

An abnormal growth that does not contain cancer and does not spread to lymph nodes or other areas of the body.

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Biopsy

The removal of a tissue sample to see if cancer cells are present and to determine the exact type of cancer.

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Brachytherapy

Treatment that uses implanted seeds, needles or other material that emits radiation, near or at the site of the tumor, with the objective of maximizing local radiation to the tumor while sparing surrounding tissues.

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Breathiness

Voice quality characteristic; may be associated with a higher pitched sound and is caused by too much air traveling through the vocal cords during speech.

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C

Cancer

The general name for a group of more than 100 diseases in which abnormal cells grow out of the normal controls of the body’s defense systems. Unlike benign tumors, cancers often have the ability to spread to other parts of the body.

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Cancer Support Group

A group formed by people diagnosed with cancer in order to provide emotional support for one another and share information, such as how to communicate with health care professionals and how best to navigate the various issues and challenges associated with cancer and cancer treatment.

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Carcinogen

A substance that causes cancer.

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Cell

The basic unit that constitutes organic tissue; at least one cell makes up every living thing.

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Chemotherapy

Treatment with drugs to inhibit cancer cell division and to destroy cancers.

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Clinical Trials

Studies that use human subjects and are designed to evaluate the optimal dosage and safety of a new drug or medical device, and whether the new drug or medical device is an effective treatment.

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Commando Procedure

An aggressive type of surgery that removes large pieces of tissue, parts of the mandible and all of the lymph nodes in the neck.

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Compensatory Vocal Fold Functioning

Vocal cords normally work together and contact one another during the production of speech. Sometimes there is damage in the functioning of just one vocal cord; as a way to compensate for the deficient vocal cord, the other vocal cord moves even more toward the middle than normal (to contact the inactive cord). If this happens, the person may be able to continue to speak, even with only one functioning vocal cord.

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Computed Tomography (CT)

X-ray images of the body taken from different angles; images are combined to make pictures of internal organs. The images provide a cross-sectional view of a particular part of the body.

 

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Concurrent Chemoradiation

A type of therapy that uses both chemotherapy and radiation therapy at the same time; this type of therapy is often more effective than using one therapy alone (i.e., chemotherapy) or using the treatments sequentially (i.e., chemotherapy followed by radiotherapy).

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Craniofacial Resection

Surgical procedure to remove tissue at the base of the skull; may include bones of the face.

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Cyberknife

Robotic stereotactic radiosurgery is a type of therapy that can be used to administer radiation to the site of the tumor, while minimizing the dosage to surrounding normal tissues.

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Cytologist

A pathologist with special training examining individual cells or clusters of cells, which can include the diagnosis of diseases based on the analysis of the cells.

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D

Deltopectoral Flap

Tissue from the front of the chest and the shoulder that is based near the sternum and can be used to reconstruct areas of the head and neck.

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Diadochokinetic Rates

The rate that a patient speaks alternative sounds and syllables can be used to evaluate speech problems, which can include problems with neuron functioning, muscle functioning or the removal of anatomic structures such as the tongue.

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Distant Metastasis

Cancer that has spread far from its original location to distant organs.

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DNA

Deoxyribonucleic acid (DNA) is the genetic blueprint found in each cell that codes for proteins and holds information on cell growth, division and function.

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Dysarthria

Impairment in speech, such as speaking so that the words run into one another (slurred speech) or an inability to pronounce the words clearly.

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Dysphagia

Difficulty swallowing.

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Dysphonia

Voice impairment with symptoms such as hoarseness.

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Dyspnea

Shortness of breath; difficulty breathing.

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E

Effortful Swallow

A type of swallow maneuver that patients are taught to practice if they have problems swallowing (i.e., dysphagia). This maneuver can improve tongue base movement and help with clearance of foods and liquids past this region when swallowing.

Electrolarynx

A battery-powered device that helps people speak following larynx removal.

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Electromyography (EMG)

A medical test that checks muscle health and the nerves that control muscles.

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Esophageal Speech

After the surgical removal of the larynx, which contains the vocal cords, patients can learn to speak through this alternate technique, which requires swallowing and then expelling air through the esophagus (the muscular tube that carries food to the stomach) to produce sound.

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Esophagus

The muscular tube that carries food and water from the back of the mouth/lower part of the throat to the stomach.

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F

Fibrosis

Hardening or thickening of connective tissue, which may lead to functional impairment in the affected areas.

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Fibular Free Flap

A flap of bone from the fibula (a thin, narrow elongated bone of the lower leg) that can be transplanted along with skin on the side of the calf and used to reconstruct regions of the upper and lower jaws.

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Fine Needle Aspiration (FNA)

A type of biopsy in which a needle attached to a syringe is inserted into a growth or tumor in order to remove cells that are then analyzed under a microscope.

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Fistula

A hole between two different anatomic structures or between an anatomic structure and the surface of the body. An “orocutaneous” fistula refers to an abnormal opening between the mouth and the skin of the face or neck.

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Flexible Fiberoptic Evaluation of Swallowing

A technique that uses a thin tube with a camera to transmit light and images from the back of the throat; this technique has been used to visualize and detect problems with swallowing. During this procedure, the camera, on a flexible scope, is placed through the nose and into the back of the throat to watch the flow of liquids while a patient swallows.

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Fluoride Prophylaxis

Fluoride has demonstrated efficacy in some trials to alter teeth characteristics, which can prevent cavities.

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Fluoride Treatment

Because fluoride has been shown to have properties such as the ability to build bone, it has been used to treat osteoporosis and other bone diseases.

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Frozen Section

Tissue is removed from the site of interest, frozen, sliced into a thin layer and placed onto a slide. Later, the sample is evaluated by a pathologist with a microscope. This technique is most commonly performed during a surgical procedure. It is often used to assess the margins around cancer after it is removed.

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G

Gamma Knife

A device that applies radiation to a specific point or region, particularly at or near the site of a tumor.

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Gastro-esophageal Reflux Disease (GERD)

A chronic disorder caused by the contents of the stomach or the first part of the small intestine moving backwards into the esophagus. Symptoms of this disorder include a sensation of burning or indigestion in the esophagus. Patients who experience GERD may also have symptoms in the back of their throat.

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Gastrostomy Tube

A tube inserted through the skin and into the stomach; the tube can be used to administer nutrition or medication.

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Gene

A segment of DNA that contains information that codes for a protein, such as hemoglobin, and for characteristics such as eye color or the likelihood of developing certain diseases.

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Genetic Testing

Tests performed to determine whether a person has certain gene sequences known to increase cancer risk or the risk of developing other diseases. Genetic counseling is becoming a routine part of the cancer treatment process. It may provide clues as to whether a particular disease may be present in siblings as well as the risk of spread to patients’ offspring.

Glossectomy

The removal of a portion of the tongue or the entire tongue. The adjectives “partial” and “total” are commonly placed before glossectomy to denote the extent of tongue removed. “Hemiglossectomy” refers to the removal of half of the tongue.

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Gray (Gy)

A unit of measurement of an absorbed dose of radiation.

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Growth Factors

A product that can promote the division of many types of cells. In some types of cancer, an abnormality that causes the overproduction of a growth factor or the overactivation of a growth factor receptor can cause cells to divide and promote the growth of a tumor.

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H

Hands-free Valve

The hands-free valve is a prosthetic device that enables patients to close off the trachea and speak without using their hands. Patients who have had their larynx (which contains the vocal cords) surgically removed may use this device in combination with a tracheoesophageal speaking valve.

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Heat Moisture Exchange Cassette (HME)

After the larynx has been surgically removed and the patient breathes through a hole surgically placed in the trachea (the main branch of the windpipe with cartilage), the patient often develops problems because air does not pass through the nasal passageway where it is normally warmed and humidified; therefore, the heat moisture exchange cassette is placed over the opening in the trachea in order to help humidify the inhaled air. The HME is porous and keeps moisture and warmth from the exhaled air, which can improve the quality of the inhaled air.

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Hoarseness

A voice quality characteristic; speaking in a gravely, scratchy or harsh voice.

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Hormone Therapy

Treatment with drugs that interfere with hormone production, which can kill cancer cells or slow their growth. Hormone therapy may also refer to the use of hormones that are given as pills or liquid to replace the hormones that are naturally produced by a gland that was removed during surgery.

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Hospice

Care, comfort and support for individuals with life-threatening medical conditions that cannot be cured.

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Hypernasality

A quality of voice with an extreme vibration of sound, usually heard with the pronunciation of vowels. It commonly results from the escape of air in the back of the throat that leads to an increase of air coming through the nasal passages.

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Hyponasality

A quality of voice with a low or insufficient vibration of sound. It is similar to the quality of voice that occurs when an individual has nasal congestion.

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Hypopharynx

A cavity in the throat that extends between the hyoid bone, which anchors the tongue, to the cricoid cartilage, which is a piece of cartilage that is located at the top of the trachea. The hypopharynx is the portion of the throat that connects to the esophagus, and food passes through this region en route to the stomach.

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Hypothyroidism

Caused by a decreased production of thyroid hormones. Symptoms can include fatigue, weight gain or cognitive and/or psychiatric problems.

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I

Image-guidance

This type of therapy uses computers and images, which can be collected from CT, X-ray or other techniques, of both the tumor and surrounding anatomic structures. The imaging information is then used to plan the radiation therapy so that radiation can be transmitted to the site of the tumor while sparing the surrounding normal tissues.

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Immune System

The body’s network of cells, tissues and organs that work together to protect the body from invading pathogens and disease.

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Immunotherapy

Treatments that promote or support the immune system’s response to cancer.

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Induction Chemotherapy (Neoadjuvant Chemotherapy)

Chemotherapy, or drugs that slow cell division and cause the death of cancer cells, are used first in a sequence of therapies. It commonly involves several courses of administering drugs prior to the main form of treatment, which may involve radiation or surgery. The cancer’s response to induction chemotherapy will often help to determine the rest of treatment.

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Infusion Port

If a patient is likely to need long-term and frequent access to a vein, a central venous access device, called a port, can be used. The implantable device will include a tube that inserts into the vein. The port can stay in place for an extended period of time so that samples can be collected frequently from the blood and/or medications such as chemotherapy can be administered.

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Intensity Modulated Radiation Therapy

This type of radiation therapy is used in combination with images that include the shape of the surrounding anatomic structures and the tumors, which enables the application of variable radiation intensities to the site of the tumor while sparing surrounding tissues (and minimizing radiation therapy toxicities).

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J

Jaw Range of Motion Exercise

If the patient has difficulty opening his or her mouth, the ability to open the mouth more can be improved by performing exercises to increase range of motion of the jaw. An example of a jaw range of motion exercise is as follows: Open the jaw as much as possible (without pain), maintain this position for a few seconds, relax, and then repeat the entire cycle several more times. “Trismus” refers to a limitation of jaw opening. This can be improved by stretching the tissues that have become scarred as a result of prior surgery or radiation. Stacking tongue blades between the upper and lower teeth several times a day is a commonly used technique. Mechanical devices that are placed between the upper and lower teeth accomplish the same thing by active range of motion exercises.

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L

Laryngeal Reposturing

Exercises that can be practiced to improve voice functioning.

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Laryngectomy

Surgery to remove a portion or the entire larynx, also known as the voice box (the anatomic structure that holds the vocal cords).

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Laryngectomy Tube

After the surgical removal of the larynx, which contains the vocal cords and a pathway to the lungs, a hole (stoma) is created that involves sewing the end of the windpipe to an opening in the skin of the neck. Tubing is used in combination with the stoma to maintain access to air for breathing.

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Laryngo-pharyngeal Reflux (LPR)

This disorder is caused by acid material from the stomach passing backwards up the esophagus and into the area around the larynx, which contains the vocal cords and may extend up as far as the nasal passage; symptoms of this disorder include coughing, shortness of breath, loss of voice and a sore throat.

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Laryngopharyngectomy

The surgical removal of both the pharynx, which is located at the back of the mouth and extends from the end of the nasal passage to the larynx, and the larynx, which contains the vocal cords. This procedure is commonly performed for cancers of the hypopharynx. Reconstruction of this defect requires restoration of the swallowing known as the pharyngoesophagus, which extends from the top of the throat at the level of the base of tongue, to the cervical esophagus before it enters the chest. The trachea is brought to the skin in the front of the neck as an end stoma or “laryngostoma.”

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Latissimus Dorsi Flap

The transfer and use of a portion of the latissimus dorsi, a large outer muscle on the lower part of the back, for the reconstruction of an area in the head. This muscle is commonly transferred with the overlying skin and can be used either as a regional pedical flap or a free flap.

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Localized Cancer

Cancer that is confined to the organ where it started and has not spread to other parts of the body.

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Lymph Nodes

Small bean-shaped collections of immune system tissue that remove cell waste, germs and other harmful substances from the lymphatic system. Lymph nodes fight infections and have a role in fighting cancer, but cancer can also spread to or through the lymph nodes. If this occurs, the lymph nodes may need to be removed.

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Lymphatic System

The extensive drainage network that keeps bodily fluids in balance and defends the body from infections. Cancer often spreads through the lymphatic system.

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M

Malignant Tumor

A mass of cancerous cells that may invade nearby tissues or spread (metastasize) to other areas of the body.

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Mandible

The lower jawbone.

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Mandibulectomy

Removal of a portion of or the entire mandible, or lower jawbone. Marginal and segmental mandibulectomy refer to the removal of portions of the lower jaw.

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Manometry

A test that can evaluate the pressure within the esophagus, the muscular tube that transports material to the stomach, and assess whether the esophagus is functioning correctly.

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Marginal Mandibulectomy

The removal of a portion of the lower jawbone, or mandible, without disrupting the continuity of the jaw, which would leave a gap in the bone. This technique is usually performed for more limited tumors that are not invading into the bone. The removal of an entire segment of the mandible is referred to as “segmental mandibulectomy.”

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Maxilla

The upper jawbone.

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Maxillectomy

Surgical procedure to remove all or part of the maxilla, or upper jawbone.

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Maxillomandibular Fixation

A technique to manage fractures in the midface or the lower jaw; the teeth and jaw are wired closed.

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Medical Oncologist

A physician who is specially trained to diagnose and treat cancer with chemotherapy and other drugs.

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Melanoma

A type of cancer that starts with pigmented cells called melanocytes, which are primarily located on the skin but are also found in other parts of the body such as the eye.

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Mendelsohn Maneuver

This is a type of swallowing maneuver that patients are taught to practice if they demonstrate problems swallowing (dysphagia) due to reduced movement of the larynx and reduced opening of the esophagus (i.e., upper esophageal sphincter or UES). Both of these swallow impairments can result in residue within the throat that causes aspiration (i.e., foods or liquids entering the airway/trachea) of this residue. This maneuver has been found to improve laryngeal motion and opening within the UES, resulting in a safer and more efficient swallow.

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Metastasis

Cancer cells that have spread to one or more sites elsewhere in the body, often through the lymphatic system or bloodstream.

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Microvascular Free Flap

If there is a defect in part of the body (i.e., surgical removal of a tumor that leaves an area without skin or anatomic structures), the microvascular free flap technique can be used to surgically repair the defect; mainly, tissue from one part of the body (i.e., a muscle from the back) can be used to replace and repair the missing tissue in the part of the body with the defect. A multitude of areas of the body have been identified that have an artery and vein that are vital to the success of the transfer. The blood supply to that tissue, known as a free flap, is interrupted at the “donor site” and then reconnected to an artery and vein in the head and neck near the defect known as the recipient site. Free flaps are selected based on their composition of bone, muscle and/or skin depending on the type of tissue required to reconstruct the defect. The removal of that free flap usually does not cause significant problems at the donor site. Due to the fact that the flap is transferred from one part of a patient’s body to another, there is no risk of immunologic rejection, which can happen when an organ is transferred from one individual to another. This surgical technique is challenging and must be performed at specialized centers.

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Modified Barium Swallow

A test to evaluate problems with swallowing; the patient drinks or consumes a barium liquid or paste mixture and fluoroscopy is performed to record the swallowing. Evaluation of this test helps to understand how well or poorly a patient is swallowing and may help to determine the safety of swallowing as well as what technique may be used to help a patient to effectively swallow.

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Modified Neck Dissection

The surgical removal of all of the lymph nodes in the neck. The dissected lymph nodes are then evaluated by a pathologist for the presence of cancer. A modified neck dissection differs from a radical neck dissection based on the removal of other structures such as the jugular vein, the sternocleidomastoid muscle or the spinal accessory nerve.

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Moh’s Micrographic Surgery

With this type of surgery, tissue is removed layer by layer; after excision of each layer, the sample is evaluated under the microscope to guide the decision as to the amount of subsequent tissue to be removed. This type of technique minimizes the amount of healthy tissue that is removed while removing the cancer cells. It is most commonly performed by a dermatologist.

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MRI (Magnetic Resonance Imaging)

A radiology technique that uses magnetism, radio waves and a computer to produce highly detailed images of structures in the body.

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Mucositis

Inflammation of the skin lining the digestive tracts, which can lead to mild to severe pain or complications that disrupt swallowing or eating

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N

Nasal Emission

During speech, air passes through areas outside the nasal passage; may produce a noisy sound during the pronunciation of consonants.

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Nasogastric Tube

If a patient has severe problems with swallowing, then to obtain nutrients that patient is administered liquid diets through a tube that passes through the nasal passageway to the stomach.

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Neutron Beam Radiation

A type of radiation therapy based on the use of high energy neutrons that appears to be more effective than other types of radiation therapy; in particular, there are some types of cancer that are resistant to and do not respond to conventional radiation therapy, but they do respond to treatment with neutron beams.

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Neutron Therapy

A type of radiation therapy based on the use of high energy neutrons, which appears to be more effective than other types of radiation therapy; in particular, there are some types of cancer that are resistant to and do not respond to radiation therapy but that do respond to treatment with neutron beams.

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Neutropenia

An abnormally low number of neutrophils, which are a type of white blood cell.

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No Evidence of Disease

A term that is used when examinations and tests can find no cancer in a patient who has been treated for cancer.

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Nurse Practitioner

A registered nurse with a master’s or doctoral degree who diagnoses and manages disease in close conjunction with doctors.

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O

Oncology

The field of medicine concerned with cancer, including diagnosis and treatment.

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Orbital Exenteration

The removal of the eye and adjacent tissues located in the space within the bony eye socket.

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Oropharynx

The cavity in the back of the mouth located above the larynx, which is the structure that contains the vocal cords.

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Osteointegrated Implant

An implant that will come into direct contact with bone; bone can grow around the implant in order to achieve a stable fixation between the bone and the implant. Following a period of healing, these implants can be used to anchor a prosthesis such as a denture or an artificial nose or ear.

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Osteoradionecrosis

A disorder that occurs due to radiation and results in the death of bone cells. Osteoradionecrosis occurs in different degrees of severity, which determine the type of treatment that is required.

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P

Palatal Augmentation Prosthesis (a.k.a. Palatal Lowering/Drop Prosthesis)

An artificial device that can be placed in the palate region and be used to reshape the maxilla to help with speech and/or swallowing.

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Palatal Lift

Patients who have a deficit in functioning of muscles in the pharynx region (extends from the nasal region to the top of the esophagus, a tube that carries food to the stomach) often have speaking or swallowing complications. Treatment for this deficit can include a combination of several therapies, such as speech therapy plus the use of a prosthetic device (palatal lift) that provides physical support for the soft palate and may improve functioning of the muscles in the area. It is most commonly attached to a bite plate-like device that covers the rest of the hard palate.

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Palatal Obturator

A prosthetic device that can be used to block anatomic deficits in the upper jaw (maxilla), especially surgically created holes in the palate.

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Palliative Care

Treatment aimed at improving a patient’s quality of life by relieving symptoms such as pain. Palliative treatment is not aimed at curing a disease.

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Parotid Gland

The largest of the salivary glands, the parotid gland is located under the cheek skin in front of the ear.

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Pathologist

A doctor who specializes in the classification of cells and disease diagnosis by examining tissue samples under a microscope.

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Pectoralis Flap

The transfer and use of the pectoralis major muscle, located in the front of the chest wall, for the reconstruction of an area in the head or neck. This is a very commonly used regional flap that permits transfer of chest wall skin by transposing the muscle over the collarbone without interrupting its blood supply.

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Permanent Section

Tissue is removed from the site of interest, preserved by a fixative, embedded in paraffin, sliced into a thin layer and placed onto a slide. Later, the sample is evaluated by a pathologist with a microscope. The permanent section refers to the final and definitive report following detailed analysis of a block of tissue. Unlike a frozen section, which occurs very rapidly during an operation, the permanent section may take several days to complete.

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Personalized Medicine

A term that describes diagnosing or performing medical treatments based on individuals’ unique characteristics, such as their genetic makeup or the specific characteristics of a patient’s cancer.

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PET Scan

An imaging test that uses a radioactive substance called a tracer to look for disease in the body. Uptake of the tracer is based on the metabolic activity of the tissue.

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Pharyngoesophageal Segment

An anatomic tube composed of a mucosal lining surrounded by a layer of muscle that extends from the nasal cavity to the first section of the esophagus, the muscular tube that transports food to the stomach. Problems with the functioning of the muscles of the pharyngoesophageal segment can lead to problems with swallowing.

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Phonatory Function (and Testing)

The ability to produce vocal noise can be evaluated by tests such as the maximum phonation time. To perform this test, the patient repetitively makes a sound, such as a vowel.

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Physician’s Assistant

A health care specialist who can perform basic medical services and procedures but can only perform this work under the supervision of a physician.

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Platelet

A component of blood that helps cause blood to clot to prevent bleeding.

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Primary Site

The site where cancer originated or first started growing.

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Prognosis

A medical term for predicting the likely outcome of an illness or form of treatment.

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Prosody

A rhythmic pattern used with speaking.

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Prosthodontist

Specialist with an area of expertise in dentistry and the replacement of missing tissue such as teeth from the jaw and mouth. A maxillofacial prosthodontist will often be involved in the creation of other anatomic structures such as an ear, nose or eye.

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Proton Beam Radiation

A type of treatment for head and neck cancer that applies radiation in the form of a proton beam to a tumor.

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R

Radial Forearm Flap

Tissue from the forearm can be removed and then used to reconstruct defects in the head or neck. It is a commonly used microvascular free flap that carries vascularized skin and sometimes bone from the radius.

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Radiation Oncologist

A doctor who concentrates in using radiation therapy to treat cancer.

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Radiation Simulation

In order to optimize the delivery of radiation therapy to the site of the tumor while sparing surrounding healthy tissue, a simulation and planning is done; a patient will position himself or herself as if the therapy will be administered, and images, such as a CT scan, are taken. This is part of the treatment planning process.

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Radiation Therapy

Treatment with high-energy rays (such as X-rays) to kill or shrink the cancer.

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Radical Neck Dissection

The surgical removal of all of the lymph nodes in the neck. The dissected lymph nodes are then evaluated by a pathologist for the presence of cancer.

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Reconstructive Surgery

Surgery to restore the form and function of the body.

Rectus Abdominis Flap

The transfer and use of a portion of the rectus abdominis muscle, a large flat muscle in the abdomen, for the reconstruction of an area in the head or neck. It is commonly transferred to the head and neck as a free flap with the overlying skin located on the front surface of the abdomen.

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Recurrence

The return of cancer after treatment.

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Red Blood Cells

A type of blood cell that contains hemoglobin, which carries oxygen from the lungs to other parts of the body.

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Regional Flap

While there are surgical techniques such as the microvascular flap that must be performed at specialized centers, the regional flap technique is not as complicated and does not necessitate a specialized center. Regional flap is the use of regional or nearby tissue to replace and repair the missing tissue in the part of the body with the defect. It does not require removal and repositioning in the body, and its vascular supply is maintained throughout the transfer.

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Regional Metastasis

Refers to the spread of cancer to lymph nodes in the region near the organ where the tumor originated.

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Remission

Complete or partial disappearance of cancer signs and symptoms in response to treatment. A remission may not be a cure.

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Resonance

The vibration of sound in anatomic structures, such as the larynx, which contains the vocal cords, or the pharynx and mouth; resonance is an important component for speech production.

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Respiration

The action of moving air into and out of the lungs.

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Respiratory Function (and Testing)

To evaluate whether there are breathing problems, evidence of lung disease or airway obsruction, numerous pulmonary function tests can be performed. Examples include spirometry tests, which measure air that goes into and exits the lungs, and the measurement of lung volume.

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Rhinectomy

Surgery to remove a portion of or the entire nose.

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Rhinotomy

The use of surgery to cut into the nose, usually to obtain exposure to remove a nasal tumor.

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Rigid Fixation

During reconstructive surgery, that involves the transfer of bone to the head and neck, plates and screws are often utilized to hold the transplanted bone in position allowing it to heal to the adjacent bone in order to form a solid union. Rigid fixation may also be used to hold segments of native bone in position without placing a bone graft. In this situation, the rigid fixation is designed to replicate the missing part by using a prosthesis without bone.

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Robotic Stereotactic Radiosurgery

Robotic stereotactic radiosurgery is a type of noninvasive therapy that can be used to administer radiation to the site of a tumor while minimizing the dosage to surrounding normal tissues.

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Roughness

Voice quality characteristic; may include hoarseness.

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S

Salivary Fistula

An abnormal opening in the duct of one of the salivary glands. This usually results from surgery or trauma and may lend to the development of a collection of saliva in the region of the gland due to saliva leaking into the soft tissues rather than along normal pathways into the mouth.

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Salivary Function Testing

Salivary gland functioning can be evaluated by first stimulating salivary glands by having the patient eat a piece of lemon candy or chew a piece gum; the amount of saliva produced in response to the stimulus can be collected and measured after a given unit of time. This can enable the clinician to measure the amount of saliva produced per minute, and these tests can be performed pre-treatment and post-treatment to evaluate whether salivary functioning is impaired.

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Salivary Gland

Glands that produce saliva and empty it into the mouth. The main salivary glands include the parotid and submandibular glands.

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Scapular Free Flap

A donor site located on the upper back that is commonly used to transfer a wide range of tissue, including skin and muscle as well as vasularized bone from the lateral or side portion of the scapular bone. The latissimus muscle as well as the serratus anterior muscle can be transferred as part of this free flap.

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Segmental Mandibulectomy

The removal of a through-and-through segment of the lower jaw that disrupts the continuity of that bone. This is usually reserved for more extensive tumors than those that are managed by a marginal mandibulectomy.

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Selective Lymph Node Dissection

Specific groups of lymph nodes that are likely to drain a tumor will be removed and evaluated under the microscope for signs of cancer; notably, lymph nodes that are outside the suspected area in the neck will be spared.

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Shaker Exercise

An exercise designed to increase the strength of muscles and increase the diameter of the opening of the upper esophagus, the muscular tube that carries material to the stomach.

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Side Effects

Unwanted effects of treatment, such as hair loss, which is sometimes a side effect associated with chemotherapy.

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Simulation

In order to optimize the delivery of radiation therapy to the site of the tumor while sparing surrounding, healthy tissue, a simulation and planning is done; a patient will position himself or herself as if the therapy will be administered, and images, such as a CT scan, are taken.

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Skin Graft

A patch of surgically removed skin that is transplanted or attached to another area of the body. Unlike a regional or free flap, a skin graft does not have its own blood supply and relies upon blood vessels growing into the skin graft from the recipient site.

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Staging

The extent and severity of the primary cancer tumor and whether it has spread. Staging provides a means for doctors to communicate about a patient’s condition as well as a method to group patients with the same disease for the purpose of determining the best treatment and the likelihood of response to treatment.

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Stenosis

A passage or tube within the body that becomes narrowed in diameter.

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Stereotactic Radiation

A type of therapy that uses a computer and an imaging device, such as magnetic resonance imaging (MRI) scans, to anatomically localize a tumor within the body. This information is used to plan subsequent radiation treatments; devices such as a head mask fixation system, which can make sure the person doesn’t move and that the treatment can be administered to the correct location, are often used. By pretreatment planning, radiation will be administered to specific locations but spare surrounding tissues.

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Stoma Cover

After a patient has the larynx removed, a hole (stoma) will be surgically placed in the main windpipe; an artificial device can be used instead of a larynx, which will typically include tubing, a chamber where the sound vibrates and a cover. A stoma cover, typically a fabric bib-like item, helps to keep the stoma clean and healthy by keeping dust and other particles out and warming the air during breathing.

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Stricture

A passage or tube within the body that becomes narrowed in diameter.

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Stridor

A rough sound that is made during the breathing process, which is caused by a blockage of the airways.

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Submandibular Gland

A salivary gland that is located under the lower jaw.

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Submental Flap

Tissue from the front portion of the upper neck located under the jawline that can be transplanted for the reconstruction of anatomic structures, such as the tongue, after it has been removed to treat cancer.

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Super Supraglottic Swallow

A type of swallowing maneuver that patients are taught to practice if they have problems with swallowing (i.e., dysphagia). This type of maneuver has been found to improve the functioning of anatomic structures that play a role in swallowing; specifically, this maneuver improves airway protection for swallowing.

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Surgeon

A doctor who uses incisions to remove tissue or organs from the body, such as a tumor, or to reconstruct defects on the body.

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Surgery

A type of treatment that includes an operation in which incisions are made to remove or reconstruct tissues or anatomical structures.

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Surgical Intensive Care Unit (SICU)

Patients who need to be evaluated, monitored and medically supported after surgery will stay in this specialized facility in a hospital.

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T

Thrombocytopenia

A medical condition in which a person’s blood has a low level of blood cell platelets and may be predisposed to problems with clotting.

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Tissue

A collection of cells that are united to perform a particular function.

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Tongue Range of Motion Exercise

These are a series of exercises in which the patient extends his or her tongue in a certain direction, holds the posture for a few seconds, relaxes and repeats this cycle several more times. These exercises may not only improve the patient’s ability to move the tongue in various directions, which may have been compromised with surgery, but can potentially improve the ability to swallow.

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Tongue Strength Testing

The patient is instructed to press a device between the tongue and the roof of the mouth for a few seconds; the device displays that amount of pressure exerted by the tongue.

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Tongue Strengthening Exercise

An exercise in which the patient uses his or her tongue to push as much as possible against an object, such as a tongue depressor, for a few seconds; relax; and repeat the cycle. By performing these and similar exercises, the strength of the tongue can be improved.

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Tongue-hold Maneuver (a.k.a. Masako Maneuver)

A type of swallowing maneuver that improves back throat muscle (i.e., pharyngeal constrictors) movement during swallowing. This maneuver can also improve tongue base movement and improve the muscular pressures generated on foods and liquids during swallowing.

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Trachea

A tube that carries air from the larynx, which contains the vocal cords, to the branches of the lungs. The trachea has cartilaginous rings that provide support for this structure.

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Trachea-esophageal Puncture

If a patient has the larynx removed surgically to treat cancer and can no longer speak, the first step to re-enable the patient to have a voice is to surgically create a hole (puncture) in the back wall of the trachea, the main windpipe. The puncture or opening in the back wall of the trachea extends into the front wall of the esophagus. A speaking valve is then inserted through this opening and permits air to be directed from the windpipe into the esophagus and out the mouth, thereby allowing a patient who is otherwise unable to speak to resume talking.

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Tracheostomy Tube

A tube that is placed in the surgical opening that is placed in the trachea, the main airway in order to help breathing or to allow a connection to an artificial breathing machine as a respirator or ventilator.

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Tracheotomy

A surgical procedure that creates either a temporary or permanent opening in the trachea to allow placement of a tracheostomy tube.

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Trismus

The inability to completely open the mouth, which may be due to muscles that are used for chewing having a decreased range of motion. It may also be caused by the growth of a tumor.

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Tumor

An abnormal lump or tissue mass. Tumors can be non-cancerous or cancerous.

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Tumor Grade

How abnormal cancer looks under a microscope. Cancers that appear normal have a low grade, while cancers that have more abnormal-appearing cells and tend to grow and spread more quickly have a high grade. The tumor grade affects prognosis and treatment.

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U

Ultrasound

Images using high-frequency sound waves to outline parts of the body. This is performed by placing a probe on the surface of the skin or may be placed into a body lumen such as the esophagus.

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Understandability/Intelligibility

A measure of the understandability or clarity of a person’s speech as heard by others.

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V

Videofluoroscopic Evaluation of Swallowing (a.k.a Modified Barium Swallow Procedure)

This type of instrumental assessment is conducted to identify the physiologic swallowing impairment and to determine whether any therapeutic strategies will make the swallow safer (e.g., eliminate aspiration) or more efficient (e.g., improve flow of food and liquid through the mouth and throat); the patient will swallow liquids and solids mixed with barium, which will enable the anatomic structures as well as the barium liquids and solids to be visualized in real-time during swallowing in a scan. When therapeutic strategies are introduced, changes in flow of food and liquid barium as well as improvement in structural movement during the swallow can be visualized with this type of assessment.

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Vocal Hyperfunction

A condition caused by the overuse of muscles associated with the production of speech, such as the larynx, which contains the vocal cords.

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Vocal Strain

Speaking with an intermittently harsh, gravelly voice.

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Voice Prosthesis

If a patient has the larynx and pharynx removed surgically to treat cancer and can no longer make speech, one way to enable the patient to produce a voice is to surgically create a hole in the trachea, the main windpipe with cartilage, and attach a device that can be used to replace the sound that a voice makes. Other voice prostheses include a handheld electrolarynx or a palatal vibrating device that is placed into the mouth to generate sound that the patient can modify to produce intelligible words.

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W

White Blood Cells

White blood cells are made by bone marrow and help the body fight infection and diseases.

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X

X-rays

Radiation used at low levels to produce body images on film. At high levels, X-rays are used to destroy cancer cells.

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Xerostomia

Dry mouth from reduced saliva flow.

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