ABSTRACT
Surgery was the primary treatment of head and neck tumours. However, with emphasis on quality of life and advances in chemotherapy and radiotherapy delivery, there has been a shift in the management of oropharyngeal squamous cell carcinoma. positron emission tomography-computed tomography may have a role to play in the assessment of the unknown primary tumour and to evaluate suspicious chest nodules. The main routine investigations for a patient with suspected head and neck cancer: general examination, examination under anaesthetic and biopsy. Blind biopsies are not helpful, especially when done at the time of examination under anaesthetic. It would be more useful to carry out targeted biopsies of sites with a potential to harbour tumour focci. Field change at the tumour margin – which may be present clinically, or be apparent from dysplastic changes in biopsies – is a worrying feature.
