Head and neck cancer of aircrew personnel in aeronautical medicalexpertise

Background: ENT cancers due to their location and treatment encompass a number of physical symptoms related to swallowing and communication disorders. Aim: To evaluate flight capacity of aircrew personnel with ENT cancer and consequences on fitness and waiver criteria. Cases report: Case 1: A 52 years old smoker pilot whish present laryngeal epidermoid carcinoma staged T3M0N0 and treated by total laryngectomy with curative radio-therapy (70Gy). Metastasis occurred on lumgth and death heaped after acute respiratory failure. Case 2: A 55 years old mechanic whish had rhinopharyngeal undifferentiated carcinoma staged T4N2M0 and treated with radiochemotherapy with favourable follow-up. Inability for flight was proclaimed because of severe psychological impact. Case 3: Concerned a vesiculograpillary carcinoma of thyroid gland occurring in a 46 years old helicopter pilot. After total thyroidectomy and iodine treatment, the patient has obtained complete fitness to flight. Conclusion: Fitness to flight can be controversed in ENT cancer occurs. Epidemio-clinical paraclinical, functionnel and operational criterias must be considered when wainer to be proclaimed.