Head and Neck Surgery

Odontogenic Cysts and Related Jaw Tumors

Module Summary

Although the primary area of expertise of the otolaryngologist is not is not in the dental sciences, odontogenic tumors and cysts can present as swellings in the mouth or maxillary sinuses.

Parathyroid Disease and Neoplasms

Module Summary

The parathyroid glands are important in maintaining calcium homeostasis in the body.  Abnormal parathyroid gland function can be related to intrinsic disease of a parathyroid gland/-s or be a physiologic response to other conditions. An understanding of the different parathyroid diseases will allow one to complete the appropriate patient evaluation to establish the diagnosis. Once the diagnosis is established, options for treatment may include observation, medical therapy, or surgery. When surgical therapy is required, preoperative imaging for localization is frequently utilized.

Thyroid Disease

Module Summary

Thyroid diseases are common and fortunately the vast majority of these conditions are benign. The evaluation of a patient with suspected thyroid disease involves laboratory assessment as well as imaging, with a neck ultrasound being the most appropriate initial study in the vast majority of patients. Functional diseases of the thyroid may be treated by a variety of approaches including medication, radioactive iodine therapy, as well as surgery.

Principles of Microvascular Free Tissue Transfer For Reconstruction of the Mandible, Midace, Other Prosthetics

Module Summary

Head and neck ablative surgery imparts significant functional and cosmetic impact on patients. Osteocutaneous free flap reconstruction provides reliable replacement tissues to reconstruct these complicated defects. An understanding of the tissue characteristics and function of the resected organs is essential to proper flap selection and design. Moreover, head and neck surgical wounds can often be complicated by contamination and fistula due to their location within the aerodigestive tract.

Principles of Microvascular Free Tissue Transfer For Soft Tissue Reconstruction of the Oral Cavity, Pharynx and Larynx

Module Summary

Head and neck ablative surgery imparts significant functional and cosmetic impact on patients. Sot tissue free flap reconstruction provides reliable replacement tissues to reconstruct these complicated defects. An understanding of the tissue characteristics and function of the resected organs is essential to proper flap selection and design. Moreover, head and neck surgical wounds can often be complicated by contamination and fistula due to their location within the aerodigestive tract.

Regional Advancement and Rotation Flaps for Large Defects of the Head and Neck

Module Summary

Loco-regional flaps are an invaluable alternative to free tissue transfer in the reconstruction of large head and neck defects, and offer the advantage of reduced operative time and possibly shorter postoperative hospitalization. A thorough knowledge of the advantages and limitations of the various donor sites (specifically maximal size and arc of rotation) is crucial in choosing the appropriate flap for the anticipated defect.

Principles of Neck Dissection

Module Summary

Cervical lymphanedectomy was described by Kocher in 1880. Neck dissection has become standard surgical treatment for the staging and treatment of head and neck metastasis of the upper aerodigestive tract. Current management of head and cancer demands thorough understanding of the anatomy and indication, as well as, the surgical technique that involves neck dissection.

Unknown Primary Neck Disease: Considerations and Workup

Module Summary

Head and neck cancer of unknown primary is a relatively uncommon entity. A patient will generally present with a persistent painless neck mass. Histopathologic diagnosis of the mass is needed to proceed, and needle aspiration is the preferred modality for this in order to avoid disruption of the cervical tissue planes. Efforts to identify a potential primary tumor are paramount and include a thorough physical examination, nasolaryngoscopy, anatomic and functional imaging.

Skull Base Surgery and Transfacial Surgical Approaches

Module Summary

The skull base possesses some of the most complicated anatomy encountered in head and neck surgery. Surgical approaches to the skull base necessitate an intimate understanding of the neurovascular and bony anatomy of the viscero and neurocranium. Treatment of skull base pathology begins with understanding the common pathologies encountered, their imaging characteristics, presenting symptoms and lastly, the surgical approaches to gain access to the skull base. Reconstruction and rehabilitation following treatment are vital components that warrant consideration. 
 

Neck and Parapharyngeal Space Neoplasms

Module Summary

Tumor involvement of the parapharyngeal space is a challenging aspect of head and neck surgery. Most parapharyngeal space tumors are benign of salivary gland or neurogenic origin. Modern imaging is essential for evaluation and treatment planning. Treatment is primarily surgical and various surgical approaches can be tailored to an individual neoplasm. However, observation for select patients with asymptomatic neurogenic tumors may be warranted. 

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