New ENT surgeon brings expert care to Mediclinic Hoogland
Posted on 2 Feb 2021
A sore throat, discomfort when swallowing or a new cough – these seemingly innocuous symptoms could be early warning signs of something far more serious than the flu, and something that affects a growing part of the local population.
When a middle-aged male patient presented to doctors at Mediclinic Hoogland recently, he showed no signs of illness other than a little hoarseness in his voice and impending stridor, or a narrowing of the airway.
But Dr Abongile Matimba noticed something else in the patient’s record. “These initial symptoms might not seem dangerous at first,” says the new specialist ear, nose and throat surgeon at Mediclinic Hoogland, “but when coupled with a decades-long history of smoking and drinking, they could point to cancer.”
Cancer of the larynx, or laryngeal cancer, most regularly begins in the squamous cells in the inner walls of the larynx. Smoking tobacco, which contains harmful chemicals, increases your risk of developing laryngeal cancer – a risk that rises significantly when accompanied by frequent, concomitant drinking.
Cancer that begins in the larynx can spread rapidly to nearby lymph nodes in the neck, back of the tongue, other parts of the throat and neck and even the lungs. Vague symptoms, coupled with this propensity to spread, mean many patients present to hospital once the disease is already advanced.
“When we examined him, we found a tumour on his left vocal cord, which was also paralysed,” says Dr Matimba. “He was then diagnosed with a laryngeal papillary squamous cell carcinoma, and the tumour was staged as a T3 larynx tumour.”
This diagnosis meant that the patient required a radical chemoradiation or total laryngectomy and neck dissection with adjuvant radiation. The patient chose surgery with adjuvant radiation. One challenge: this procedure had never before been performed at Mediclinic Hoogland.
In a total laryngectomy, the entire larynx is surgically removed. To ensure breathing is not affected, surgeons will then bring the trachea, or windpipe, up through the skin of the front of the neck. And in a neck dissection, surgeons will remove lymph nodes and surrounding tissue from the neck in order to control the spread of squamous cell carcinoma to the neck lymph nodes.
Usually, while the throat and the oesophagus is not affected, meaning the patient may swallow food as they did before, speech is dramatically affected. In this case, Dr Matimba and his colleagues were able to go a step further by performing an esophageal myotomy to help preserve some speech function.
A few weeks after surgery, and once it is confirmed the patient is free of cancer, he will return for voice prosthesis fitted, to help aid in the full recovery of his voice.
Dr Matimba, who hails from Ncgobo in the Eastern Cape, qualified as a Medical Practitioner (MBChB) at Walter Sisulu University in Mthatha in 2010, obtained a fellowship in Otorhinolaryngology (FCORL) in October 2019 (CMSA) and acquired a Master of Medicine in Otorhinolaryngology MMed (ORL) last year from the University of the Free State.
He specialised for four years in Otorhinolaryngology, and Head and Neck surgery at the Universitas Academic Hospital in Bloemfontein and is a member of the South African Society of Otorhinolaryngology, Head and Neck Surgery and Allergy Society of South Africa (ALLSA).