Specialised head and neck surgical oncology — with deep expertise in oral cavity cancers, parotid and salivary gland tumours, composite resections, and complex reconstructive surgery including free flap microvascular reconstruction. Cure is the goal. Function and form are preserved wherever possible.
Head and neck cancers encompass malignancies of the oral cavity, pharynx, larynx, salivary glands, thyroid, parathyroid, and skin of the head and neck region. Surgery is the primary curative modality for most oral cavity and salivary gland cancers — and the expertise of the operating surgeon directly determines both cure rates and functional outcomes.
Dr. Gore's training in Head & Neck Oncology at Tata Memorial Hospital, Mumbai — one of Asia's highest-volume head and neck cancer centres — combined with three years of plastic and reconstructive surgery at Sassoon General Hospital, Pune, gives him a uniquely comprehensive skill set: oncological resection with the expertise to reconstruct complex defects using local, regional, and free flap techniques. This combination — oncological and reconstructive — is not available from every surgeon.
His research publications in oral cancer reconstruction and salivary gland tumours, and a prospective database of 200+ laryngectomy with TEP voice rehabilitation cases, reflect the depth of his head and neck oncology experience.
In head and neck cancer surgery, the stakes are uniquely high — because the structures we operate on define who the patient is: their voice, their ability to swallow, their face. Every operation must balance oncological clearance — which cannot be compromised — with the best possible functional and aesthetic outcome.
My training at Tata Memorial gave me the oncological framework, and three years in plastic and reconstructive surgery at Sassoon gave me the reconstructive tools. Together, they allow me to resect oral cancers with clear margins and then reconstruct the defect — sometimes immediately — using the most appropriate flap for that specific patient. The result is cure without the patient losing more function than absolutely necessary.
— Dr. Vinod T. Gore, MBBS MS FAIS FIAGES FARIS (Edin)Laryngeal and pharyngeal cancers are primarily managed with organ-preservation chemoradiation protocols — surgery reserved for salvage or when radiation has failed. Dr. Gore's surgical role is in selected laryngectomy and voice rehabilitation.
Squamous cell carcinoma of the larynx (glottis, supraglottis, subglottis) — early stages (T1–T2) are treated with radiotherapy or endoscopic laser resection, achieving excellent voice preservation. Locally advanced disease (T3–T4) receives concurrent chemoradiation (Cisplatin + 70 Gy) as the organ-preservation standard. Total laryngectomy is reserved for radiation failure, T4b disease with cartilage destruction, or when organ preservation is oncologically not feasible. Dr. Gore performs total laryngectomy with primary tracheoesophageal puncture (TEP) for voice rehabilitation — placing the voice prosthesis at the time of laryngectomy so patients recover with a functioning voice.
Primary: Chemoradiation · Surgery for SalvageOropharyngeal cancer (base of tongue, tonsil, soft palate, posterior pharyngeal wall) — predominantly driven by HPV (HPV-positive oropharyngeal cancer has an excellent prognosis). Nasopharyngeal cancer is treated with radiation ± chemotherapy — surgery rarely needed. Hypopharyngeal cancer (pyriform sinus, posterior pharyngeal wall) — concurrent chemoradiation is standard; surgery for failures or T4 disease. For selected resectable oropharyngeal cases, TORS (Transoral Robotic Surgery) allows minimally invasive tumour removal without pharyngotomy.
Primary: Chemoradiation · TORS for Selected CasesTotal laryngectomy does not mean permanent silence. Dr. Gore performs primary TEP at the time of laryngectomy — placing a voice prosthesis that allows patients to speak by diverting airflow through the tracheoesophageal party wall. He maintains one of India's largest prospective databases of post-laryngectomy voice rehabilitation with TEP.
Parotid tumours — ranging from benign pleomorphic adenomas to malignant carcinomas — require expert surgical management to achieve complete excision while preserving the facial nerve, which courses through the parotid gland and controls all facial expression.
The parotid gland is the largest salivary gland, lying in front of and below the ear. It is intimately related to the facial nerve (VII) — the nerve that controls all facial expression — which divides into its five branches (temporal, zygomatic, buccal, marginal mandibular, cervical) as it passes through the parotid. Any operation on the parotid must identify and preserve this nerve; inadvertent damage causes permanent facial palsy.
The majority of parotid masses are benign — most commonly pleomorphic adenoma (the most common salivary gland tumour) — but all require surgical excision for definitive histological diagnosis and to prevent malignant transformation. The standard operation is superficial parotidectomy — removing the superficial lobe of the gland with systematic facial nerve identification and preservation.
Malignant parotid tumours require total parotidectomy with wider soft tissue margins and, in higher-grade cancers, sacrifice of involved facial nerve branches with immediate nerve grafting using the great auricular nerve or sural nerve. Neck dissection is added for clinically or radiologically node-positive necks.
Dr. Gore has published research on salivary gland tumours and has extensive experience in parotid surgery — with meticulous facial nerve dissection as the technical foundation of every parotidectomy.
Most common parotid tumour — slow-growing, lobulated, mobile. Treated by superficial parotidectomy with complete capsule removal. If incompletely excised, high recurrence rate (30%) — complete excision with facial nerve preservation is essential.
Benign — 80% of parotid tumoursSecond most common — bilateral in 10% of cases. Associated with smoking. Soft, cystic, fluctuant parotid swelling. Benign — treated by superficial parotidectomy. No malignant potential.
BenignMost common malignant salivary tumour. Low-grade behaves almost benignly; high-grade is aggressive with nodal metastasis. Wide local excision / total parotidectomy + selective neck dissection for high-grade. Adjuvant radiotherapy for high-grade or positive margins.
Malignant — Most CommonCharacterised by perineural invasion — notorious for tracking along facial nerve branches. Slow growing but relentless — high rate of distant lung metastases. Total parotidectomy with nerve sacrifice if involved. Adjuvant radiation essential. Long-term surveillance mandatory.
Malignant — Perineural SpreadEvery parotid operation requires systematic identification and dissection of the facial nerve — from the main trunk at the stylomastoid foramen through all five divisions. This meticulous nerve dissection is the most demanding technical aspect of parotid surgery.
Submandibular & Sublingual Gland Tumours: Submandibular gland tumours have a higher malignancy rate (~50%) than parotid tumours. Treatment is excision of the submandibular triangle contents including the gland, with preservation of the marginal mandibular branch of the facial nerve, lingual nerve, and hypoglossal nerve.
Oral cavity cancers — predominantly squamous cell carcinoma — are among the most surgically curable head and neck cancers when treated with clear-margin resection and appropriate reconstruction. India carries one of the world's highest oral cancer burdens, largely driven by tobacco and betel nut use.
Oral cavity cancer surgery follows one overriding oncological principle: achieve clear surgical margins (≥5mm histologically confirmed) — this is the single most important determinant of local recurrence and survival. Every other consideration — function, reconstruction, aesthetics — is secondary to oncological clearance.
Surgery for oral cancers involves two simultaneous operations: resection of the primary tumour (hemiglossectomy, buccal mucosa excision, composite resection) and neck dissection — because oral cancers drain predictably to cervical lymph nodes and occult nodal metastases are present in 20–30% of clinically node-negative patients with T2+ tumours.
The resulting defect — which may involve loss of tongue, floor of mouth, cheek lining, mandible, or palate — is then reconstructed immediately at the same operation. Immediate reconstruction is the standard: it reduces hospital stay, accelerates recovery, prevents contracture, and restores function faster than delayed reconstruction.
The most common oral cavity site in India — lateral border and ventral tongue are the most frequent locations. Hemiglossectomy (removal of half the tongue) or subtotal glossectomy depending on tumour extent. Frozen section of the deep margin is critical — tumour depths ≥4mm on ultrasound require elective neck dissection even in cN0 patients.
Lining of the cheek — extremely common in tobacco-chewers and betel nut users. Buccal mucosal cancers are notorious for close proximity to the buccinator muscle, buccal fat pad, and skin — requiring en-bloc excision with adequate deep margin. Tumours invading the buccinator or skin require full-thickness cheek resection with reconstruction.
Cancers of the upper and lower alveolar ridge (gum) and retromolar trigone frequently invade the underlying mandible (lower jaw) or maxilla (upper jaw). Mandibular involvement requires partial or segmental mandibulectomy — removal of a segment of the mandible — with immediate reconstruction using the fibula free flap, which provides both bone and soft tissue for three-dimensional reconstruction of the jaw.
Floor of mouth cancers lie in close proximity to the lingual nerve, hypoglossal nerve, Wharton's duct, and the mandible — requiring precise anatomical dissection. Involvement of these structures requires controlled sacrifice with reconstruction. Hard palate cancers may require maxillectomy — the defect communicates with the nasal cavity and requires either obturator prosthesis or flap closure.
Cervical lymph node metastasis is the single most important prognostic factor in oral cavity and head and neck cancer — halving survival when nodes are involved. Neck dissection is a surgical, staging, and therapeutic procedure performed at the time of primary tumour excision.
The neck is divided into six levels — each draining specific head and neck subsites. The choice of neck dissection type depends on whether nodes are clinically involved (cN+) and which levels are at risk based on the primary tumour site.
For clinically node-positive necks (cN+) — comprehensive neck dissection removing all involved nodal levels is performed. Adjuvant chemoradiotherapy is given when there are multiple positive nodes, extranodal extension (ENE), or positive surgical margins.
For clinically node-negative necks (cN0) in patients with T2+ oral cancers or depth of invasion >4mm — elective selective neck dissection (levels I–III for oral cavity primaries) is performed, because 20–30% of these patients have occult micrometastases not detectable on imaging. Finding and treating these occult metastases at the primary operation significantly improves cure rates.
Removes specific nodal levels at risk based on primary site — spares the sternocleidomastoid muscle (SCM), internal jugular vein (IJV), and accessory nerve. Best functional outcome. Standard for elective (cN0) neck management and selected cN+ cases.
Removes levels I–V while preserving one or more non-lymphatic structures (SCM, IJV, or accessory nerve). For cN+ disease — comprehensive clearance with better functional outcome than radical dissection. Dr. Gore's preferred approach for cN+ oral cancers.
Removes levels I–V including SCM, IJV, and accessory nerve — reserved for tumours directly invading these structures. Significant functional morbidity (shoulder dysfunction from accessory nerve sacrifice). Used only when oncologically necessary.
Bilateral neck dissection is performed for midline oral cavity primaries (floor of mouth, anterior tongue, lower lip) — where bilateral nodal drainage creates equal risk on both sides. Both sides are cleared at the same operation, staged if vascular anatomy dictates.
Dr. Gore's three years of plastic and reconstructive surgery training at Sassoon General Hospital — alongside his Head & Neck Oncology training at Tata Memorial — gives him the dual expertise to resect and reconstruct in the same operation. The goal: oncological cure without sacrificing form or function.
Reconstruction of head and neck defects is one of the most technically demanding areas in surgery. The face and oral cavity demand not just structural coverage but functional restoration — the reconstructed tongue must move; the rebuilt jaw must be symmetric; the reconstructed cheek must close the mouth; the flap covering the pharynx must not obstruct swallowing.
This requires expertise in three categories of reconstruction — local flaps (tissue from immediately adjacent to the defect), regional pedicled flaps (tissue brought from a distance on its blood supply), and free flaps (tissue completely disconnected from its origin and reattached by microsurgical anastomosis of vessels). The choice depends on defect size, location, available local tissue, and patient factors.
Dr. Gore's published research on "Reconstruction of defects caused by ablation of oral malignancy" reflects his systematic study and clinical expertise in this area — choosing the right reconstruction for each specific defect, every time.
Oral cavity cancer surgery offers some of the best cure rates in head and neck oncology — when performed with clear margins and appropriate reconstruction by an experienced surgical team. Stage is the most important determinant of outcome, followed by margin status and nodal disease.
For oral cavity cancer, parotid tumours, or any head and neck cancer concern — book a consultation with Dr. Gore for a complete assessment, staging workup, and personalised surgical plan with reconstruction.