Head and Neck Surgery: Surgical Landmark and Dissection Guide

Foreword
Foreword
Foreword
Preface
Acknowledgment
Contents
About the Editors
1: Introduction to Head and Neck Surgery
1.1 Introduction
1.2 Head and Neck Anatomy
1.3 Role of Imaging Complementing the Anatomical Details Necessary for a Surgical Mapping
1.4 Anatomical Landmark of Head and Neck Region
1.4.1 Thyroid and Parathyroid Glands
1.5 Surgical Landmarks of Selected Head and Neck Surgery
1.5.1 Transverse Process of the First Cervical Vertebra
1.5.2 Parapharyngeal and Retropharyngeal Space
1.5.3 Sentinel Lymph Node Biopsy
1.6 Dissection Procedure
1.6.1 Pearls and Pitfalls of Dissection Techniques
1.6.2 Dissection Guide
1.7 Optimal Setting for Head and Neck Cancer Surgery
1.8 Availability of Necessary Instrument and Supportive Staffs
1.9 Conclusion
References
2: Principle of Head and Neck Surgery and the Importance of Anatomical Characteristics
2.1 Introduction
2.2 Principle of Surgery for Head and Neck Cancer
2.3 Types of Head and Neck Surgery
2.3.1 Oral Cavity Surgery
2.3.2 Pharyngeal Surgery
2.3.3 Transoral Robotic Surgery (TORS)
2.4 Laryngeal Surgery
2.5 Nasal Cavity and Nasopharyngeal Surgery
2.6 Salivary Gland Surgery
2.7 Thyroid Gland Surgery
2.8 Neck Dissection
2.9 Ear and Temporal Bone Surgery
2.9.1 Paediatric Surgery
2.10 Anatomical Versus Surgical Landmarks
2.11 Techniques of Dissection
2.12 Pearls and Pitfalls of Head and Neck Surgery
2.13 Conclusion
References
3: Significance of Anatomical Versus Surgical Landmarks in Head and Neck Surgery
3.1 Introduction
3.2 Importance of Surgical Landmarks
3.3 Thyroid Surgery and Related Surgical Landmarks
3.4 Salivary Gland Surgery and Surgical Landmark
3.5 Oral Cavity and Oropharyngeal Surgery
3.6 Laryngeal and Pharyngeal Surgical Landmark
3.6.1 Pharynx
3.6.2 Nasopharyngeal Surgery
3.6.3 The Importance of Surgical Landmark During Neck Dissection
3.6.4 Sinus and Paranasal Sinus Surgery
3.6.5 Skull-Based Surgery and Landmarks
3.6.6 Temporal Bone Surgery
3.7 Conclusion
References
4: Radiological Assessment and Its Roles in Head and Neck Surgical Oncology
4.1 Introduction of Head and Neck Squamous Cell Carcinoma
4.1.1 Clinical Presentation and Assessment of Head and Neck Malignancy
4.1.2 Cross-Sectional Imaging of Head and Neck Tumours
4.2 Preoperative Imaging Evaluation
4.2.1 Perineural Tumour Spread
4.2.2 Carotid Artery Involvement
4.2.3 Invasion of Prevertebral Space
4.2.4 Bone and Cartilage Invasion
4.3 Imaging Highlights of Head and Neck Anatomy
4.3.1 Oral Cavity
4.3.2 Nasopharynx
4.3.3 Oropharynx
4.3.4 Hypopharynx
4.3.5 Larynx
4.4 The AJCC Head and Neck Tumour Classification Changes
4.4.1 Oral Cavity Squamous Cell Carcinoma
4.4.2 Oropharyngeal Squamous Cell Carcinoma
4.4.3 Nasopharyngeal Squamous Cell Carcinoma
4.4.4 Non-HPV Oropharyngeal Squamous Cell Carcinoma
4.4.5 Unknown Primary Tumours
4.4.6 Tumour Types Without Changes from the 7th Edition of AJCC
4.5 Lymph Nodes
4.5.1 Introduction
4.5.2 Radiologic Criteria for Assessment of Head-Neck Lymph Nodes
4.5.2.1 Clustering
4.5.2.2 Morphology
4.5.2.3 Inhomogeneity
4.5.2.4 Size
4.5.2.5 Lymphatic Drainage
4.6 Advanced Imaging
4.6.1 Elastography
4.6.2 DWI-MRI
4.7 Preoperative Imaging for Thyroid Cancer Surgery
4.7.1 Introduction
4.7.2 Preoperative Imaging Examination
4.7.3 Ultrasound Evaluation of Primary Tumour
4.7.4 Risk Stratification Systems
4.8 Ultrasound Findings in Benign and Malignant Lymph Nodes
4.9 Ultrasound in Presurgical Planning
4.9.1 Preoperative Ultrasound Role in Malignant Cytology
4.9.2 Preoperative Ultrasound Role in Indeterminate or Suspicious Cytology
4.10 Ultrasound in Revision Surgery
4.11 Cross-Sectional Imaging
4.11.1 Cross-Sectional Imaging Evaluation of the Primary Tumour
4.11.2 Cross-Sectional Imaging in the Assessment of Cervical Lymph Nodes
4.11.3 Cross-Sectional Imaging Assessment in Revision Surgery
4.12 The Post-treatment Role of Radiology
References
5: Approach Towards Oral Cavity Cancers
5.1 Introduction
5.2 Principles of Management
5.2.1 Role of Neoadjuvant Chemotherapy
5.3 Diagnostic Evaluation
5.4 Principles of Imaging Techniques
5.5 Assessment of Depth of Invasion
5.6 Imaging for Cervical Metastasis
5.7 Imaging for Distant Metastasis
5.8 Approaches to Surgical Resection
5.8.1 Principles of Resection
5.8.2 Extent of Resection and Margins
5.8.2.1 Access-Incision Planning
5.8.3 Surgical Techniques
5.8.3.1 Anaesthesia Considerations
5.8.4 Early Tongue Carcinoma (T1 and T2 Tumours or T3/T4 Tumours That Are Completely Visualized)
5.8.4.1 Peroral Wide Local Excision
5.8.5 Advanced Tongue Carcinoma (T3 and T4 or Posteriorly Based T1 and T2 Tumours)
5.8.5.1 Access Osteotomy Through Mandibulotomy
5.8.5.2 Surgical Steps
5.8.5.3 Pull-Through Approach
5.8.5.4 Oral Component
5.8.5.5 Neck Component
5.8.6 Early Buccal Mucosa (T1 and T2)
5.8.6.1 Peroral Wide Local Excision
5.8.6.2 Wide Local Excision with Marginal Mandibulectomy
5.8.6.2.1 Surgical Steps
5.8.7 Buccal Mucosa Composite Resection (T3 and T4)
5.8.8 Buccal Mucosa Composite Resection with Posterior Segmental Mandibulectomy
5.8.9 Modifications for Segmental Mandibulectomy
5.8.10 Modifications for Bite Composite Resection with/Without Infratemporal Fossa Contents
5.8.11 Hard Palate (T1–T2 Lesion)
5.8.11.1 Upper Alveolectomy
5.9 Broad Tips for Reconstruction
References
6: Oropharyngeal and Hypopharyngeal Tumours and Their Treatment
6.1 Benign Oropharyngeal Tumours
6.1.1 Lingual Thyroid
6.1.2 Epidemiology
6.1.3 Clinical Presentation
6.1.4 Histology
6.1.5 Imaging
6.1.6 Blood Investigation
6.1.7 Treatment
6.1.8 Surgical Treatment
6.1.9 Non-surgical Treatment
6.2 Pleomorphic Adenoma
6.2.1 Diagnosis
6.2.2 Biopsy and Histology
6.2.3 Treatment
6.2.4 Case Illustration 1
6.3 Papilloma
6.3.1 Epidemiology
6.3.2 Clinical Presentation
6.3.3 Histology
6.3.4 Treatment
6.4 Oropharyngeal Squamous Cell Carcinoma
6.4.1 Risk Factors
6.4.2 Clinical Presentation
6.4.3 Diagnosis
6.4.4 Histology
6.4.5 Imaging
6.4.6 Staging
6.4.7 Treatment
6.4.8 Early Stage
6.4.9 Advanced Stage
6.4.10 Non-surgical Treatment
6.4.11 Case Illustration 1
6.4.12 Case Illustration 2
6.5 Benign Hypopharyngeal Tumours
6.5.1 Fibrolipoma
6.6 Hypopharyngeal Squamous Cell Carcinoma
6.6.1 Epidemiology
6.6.2 Risk Factor
6.6.3 Clinical Presentation
6.6.4 Diagnosis
6.6.5 Blood Investigations
6.6.6 Imaging
6.6.7 Endoscopic Examination Under General Anaesthesia
6.6.8 Histology
6.6.9 Staging
6.6.9.1 Primary Tumour (T)
6.6.9.2 Regional Lymph Node (N)
6.6.9.3 Distant Metastasis (M)
6.6.9.4 Stage Groups
6.6.10 Treatment
6.6.10.1 Surgical
6.6.10.2 Non-surgical: Chemotherapy and Radiotherapy
References
7: Surgical Management of Nasopharyngeal Carcinoma
7.1 Introduction
7.2 Salvage Neck Dissection
7.2.1 Roles of Flaps in Salvage Neck Dissection
7.3 External Access for Nasopharyngectomy: Lip Split, Maxillary Swing, Midfacial Degloving
7.3.1 Patient Selection and Preoperative consideration
7.3.2 Transoral-Transpalatine Approach (Fig. 7.2)
7.3.2.1 Procedure
7.3.2.2 Advantages
7.3.2.3 Disadvantages
7.3.3 Transmandibular-transcervical approach
7.3.3.1 Procedure
7.3.3.2 Advantages
7.3.3.3 Disadvantages
7.4 Anterolateral Approach: Maxillary Swing
7.4.1 Procedure
7.4.2 Advantages
7.4.3 Disadvantages
7.5 Lateral Infratemporal Fossa Approach Type C
7.5.1 Procedure
7.5.2 Advantages
7.5.3 Disadvantages
7.6 Subtemporal-Preauricular Infratemporal Fossa Approach
7.6.1 Procedure
7.6.2 Advantages
7.6.3 Disadvantages
7.7 Facial Translocation
7.7.1 Procedure
7.7.2 Advantages
7.7.3 Disadvantages
7.8 Endoscopic Endonasal Transpterygoid Nasopharyngectomy (EETN)
7.8.1 Patient Selection
7.8.2 Surgical Technique
7.8.2.1 Nasoseptal Flap
7.8.2.2 Sinonasal Corridor
7.8.2.3 Posterior Septectomy
7.8.2.4 Inferior Sphenoidectomy
7.8.2.5 Transpterygoid Dissection
7.8.2.6 Tumour Extirpation
7.8.2.7 Nasopharyngeal Reconstruction
7.9 Post-operative Care and Complications
7.10 Miscellaneous
7.11 Conclusion
References
8: Salivary Glands Tumours and Its Surgery
8.1 Introduction
8.2 Clinical Presentation of Salivary Gland Tumour
8.3 Surgical Anatomy of Salivary Glands
8.4 Facial Nerve Surgical Anatomy
8.5 Roles of Imaging in Parotid Gland Surgery
8.6 Parotid Gland Surgery
8.6.1 Benign Parotid Tumour Surgery
8.6.2 Malignant Parotid Tumour Surgery
8.7 Surgical Techniques and Dissection
8.7.1 Superficial Parotidectomy
8.7.1.1 Patient Positioning and Facial Nerve Application
8.7.1.2 Skin Incision
8.7.1.3 Raising of the Skin Flap
8.7.1.4 Greater Auricular Nerve Preservation
8.7.1.5 Skeletonization of SCM Muscle
8.7.1.6 Dissection at the Tragal Area
8.7.1.7 Facial Nerve Trunk Identification
8.7.1.8 Facial Nerve Branch Preservation
8.7.1.9 Removal of the Parotid Mass
8.7.1.10 Homeostasis Control
8.7.1.11 Drain Insertion and Wound Closure
8.7.1.12 Post-operative Follow-Up
8.7.2 Total Parotidectomy with Facial Nerve Preservation
8.7.2.1 Case Illustration 1
8.7.2.1.1 Step 1: Patient’s Positioning and Surgical Landmark Identification
8.7.3 Case of Extended Total Parotidectomy with Skin Excision and Flap Reconstruction
8.7.4 Cases of Recurrent Adenocystic Carcinoma in a Young Female
8.8 Complications Post Parotidectomy
8.9 Submandibular Gland Surgery
8.9.1 Steps in Submandibulectomy
8.9.2 Post-operative Assessment
8.10 Complications of Submandibulectomy
8.11 Prognosis of Patients with Salivary Gland Tumours
8.12 Conclusion
References
9: Thyroid Gland Tumour and Surgical Approach with Case Illustration
9.1 Introduction
9.2 Surgical Anatomy of Thyroid Glands
9.2.1 Recurrent Laryngeal Nerve
9.2.2 Non-recurrent Laryngeal Nerve
9.2.3 Berry’s Ligament
9.2.4 Parathyroid Gland Anatomy
9.2.5 Inferior Thyroid Artery
9.2.6 Zuckerkandl Tubercle
9.3 Clinical Presentation of Thyroid Tumours
9.4 Imaging Modalities for Assessment of Thyroid Malignancy
9.5 Retrosternal Thyroid Tumour
9.6 Choices and Types of Thyroidectomy
9.6.1 Endoscopic Thyroidectomy and Robotic Thyroidectomy
9.7 Intraoperative Neural Monitoring
9.8 Total Thyroidectomy for Papillary Thyroid Carcinoma
9.9 Thyroid Lobectomy
9.9.1 Case Illustration 1: Completion Hemithyroidectomy
9.10 Conclusion
References
10: Endoscopic Nasal and Paranasal Sinus Surgery
10.1 Introduction
10.2 Surgical Anatomy
10.3 Indications
10.4 Preoperative Evaluation and Surgical Preparation
10.4.1 Patient Preparation
10.4.2 Informed Consent
10.4.3 Preoperative Planning/Evaluation
10.4.4 Preoperative Measure to Reduce Intraoperative Bleeding
10.4.4.1 Antibiotic
10.4.4.2 Systemic Corticosteroid
10.4.4.3 Topical Decongestants
10.4.4.4 Adrenaline
10.4.4.5 Moffett’s Solution
10.4.5 Anaesthesia
10.4.6 Positioning of Patient
10.4.7 Image-Guided System (IGS)
10.5 Operative Techniques
10.5.1 Endoscopic Sinus Surgery
10.5.1.1 Uncinectomy
10.5.1.2 Middle Meatal Antrostomy (MMA)
10.5.1.3 Ethmoidal Bullectomy
10.5.1.4 Posterior Ethmoidectomy
10.5.1.5 Sphenoidotomy
10.5.1.6 Frontal Sinusotomy
10.6 Intraoperative Complication
10.6.1 Intranasal Complications
10.6.1.1 Haemorrhage from Mucosa
10.6.1.2 Arterial Injury
10.6.1.2.1 Sphenopalatine Artery
10.6.1.2.2 Anterior Ethmoidal Artery (AEA)
10.6.1.2.3 Posterior Ethmoidal Artery (PEA)
10.6.1.2.4 Internal Carotid Artery (ICA)
Call for Help
Secure the Bleeding
Interventional Radiologist/Endovascular
10.6.1.3 Injury to Surrounding Structures
10.6.2 Intraorbital Complications
10.6.2.1 Breach of the Lamina Papyracea and Orbital Fat Injury (Grade I)
10.6.2.2 Orbital Emphysema (Grade I)
10.6.2.3 Intraorbital Haematoma (Grade I)
10.6.2.4 Injury to the Lacrimal Duct (Grade II)
10.6.2.5 Extraocular Muscle Injury (Grade III)
10.6.2.6 Optic Nerve Injury (Grade III)
10.6.3 Intracranial Complications
10.6.3.1 CSF Leak
10.6.4 Post-operative Complication
10.6.4.1 Epistaxis
10.6.4.2 Nasal Synechia
10.6.4.3 Other Complications
References
11: Surgical Approaches to the Maxilla, Maxillary Sinus, Pterygopalatine Fossa, and Infratemporal Fossa for Malignant Tumors
11.1 Introduction
11.2 Anatomical Landmarks
11.3 Background
11.4 Patient’s Preparation
11.5 Equipment
11.6 Positioning
11.7 Preoperative Evaluation
11.8 Infrastructure Maxillectomy
11.9 Subtotal Maxillectomy
11.10 Total Maxillectomy
11.11 Transnasal Endoscopic Median Maxillectomies
11.12 Transoral-Transnasal Endoscopic Maxillectomy
11.13 Endoscopic-Assisted Transfacial Maxillectomy
11.14 Conclusion
References
12: Laryngeal Disease and Tumours and Its Related Surgery
12.1 Introduction
12.2 Anatomy of the Larynx
12.3 Laryngeal Diseases
12.4 Supraglottic Carcinoma
12.5 Glottic Carcinoma
12.6 Subglottic Carcinoma
12.7 Diagnosis: Investigation Tools
12.8 Surgical Treatment
12.9 Surgical Steps Common to All Types of Laryngectomies
12.9.1 Skin Incision
12.9.2 Detachment of the Myo-cutaneous Flap
12.9.3 Incision of the Deep Cervical Fascia Along the Anterior Border of the  Sternocleidomastoid Muscle
12.9.4 Exposure of the Larynx
12.9.5 Larynx Skeletonization
12.9.6 Management of the Laryngeal Neurovascular Pedicle
12.10 Open Partial Horizontal Laryngectomy (OPHL)
12.10.1 Horizontal Supraglottic Laryngectomy: OPHL Type I
12.10.1.1 Surgical Technique
12.10.2 Horizontal Supracricoid Laryngectomy: OPHL Type II
12.10.2.1 Surgical Technique
12.10.3 Horizontal Supratracheal Laryngectomy: OPHL Type III
12.10.3.1 Surgical Technique
12.11 Total Laryngectomy
12.11.1 Surgical Technique
12.12 Future Challenges
12.13 Conclusion
References
13: Neck Dissections in Head and Neck Malignancy
13.1 Introduction
13.2 Risk Factors of Neck Metastases
13.3 Principle of Neck Dissection
13.4 Classification of Neck Dissection
13.5 Central Compartment Neck Dissection
13.6 Selective Neck Dissection
13.7 Surgical Techniques with Cases Illustrations
13.7.1 Selective Neck Dissection
13.7.2 Case Illustration 1
13.7.3 Case Illustration 2
13.7.4 Case Illustration 3
13.8 Modified Radical Neck Dissection
13.9 Radical Neck Dissection
13.10 Post-operative Care and Complications
13.11 Prognosis
13.12 Conclusion
References
14: Head and Neck Surgical Access in the Management of Head and Neck Malignancy
14.1 Introduction
14.2 Importance of Adequate Surgical Access
14.3 Endoscopic Assisted Surgical Access
14.3.1 Endoscopic Thyroidectomy
14.3.2 Endoscopic Nasopharyngectomy
14.4 Transoral Robotic Head and Neck Surgery (TORS)
14.4.1 TORS in Laryngeal and Pharyngeal Surgery
14.4.2 TORS in Neck Dissection
14.5 Sternotomy in Thyroid and Superior Mediastinal Tumour
14.5.1 Surgical Steps of Sternotomy
14.5.2 Other Approaches in Thyroid and Superior Mediastinal Tumour
14.6 Mandibulotomy and Mandibulectomy
14.7 Clavicle Osteotomy
14.7.1 Case Illustration
14.7.1.1 Case 1
14.8 Base-of-Neck Tumour
14.9 Impacts on Treatment Outcomes
14.10 Complications and Prognosis of Head and Neck Malignancy
14.11 Conclusion
References
15: Orbital Exenteration in Head and Neck Malignancy
15.1 Introduction
15.2 Orbital Exenteration
15.2.1 Surgical Steps
15.2.1.1 Lid-Sparing Exenteration
15.2.1.2 Total Exenteration
15.2.2 Case Illustrations
15.2.3 Complications
15.2.4 Reconstruction Option Following Orbital Exenteration
15.3 Impact of Orbital Exenteration
15.4 Conclusion
References
16: Temporal Bone Diseases and Tumours and Its Related Surgery
16.1 Introduction
16.2 Surgical Pathology of the Temporal Bone
16.2.1 Benign Pathology
16.2.1.1 Chronic Otitis Media with Cholesteatoma
16.2.1.2 Temporal Bone Fracture with Facial Nerve Palsy
16.3 Sensorineural Hearing Loss and Cochlear Implant Surgery
16.4 Vestibular Disorders
16.4.1 Ménière’s Disease
16.4.2 Superior Semicircular Canal Dehiscence
16.5 Benign Tumours of the Temporal Bone
16.5.1 Middle-Ear Glandular Neoplasms: Adenoma, Neuroendocrine Adenoma, and Carcinoid Tumours
16.5.2 Vestibular Schwannoma and Other Cerebellopontine Angle Neoplasms
16.5.3 Temporal Bone Paraganglioma
16.6 Malignant Neoplasms
16.6.1 Squamous Cell Carcinoma of the Temporal Bone (SCCTB)
16.7 Investigation Tools for Temporal Bone Diseases
16.7.1 Diagnostic Audiology
16.7.2 Vestibular Tests
16.7.3 Imaging
16.8 Anatomical Landmarks and Surgical Procedures
16.8.1 Surgical Approaches and Incisions
16.8.2 Postauricular Incision
16.8.3 Transmeatal Incisions
16.8.4 Endaural Incisions
16.8.5 Incisions for the Middle Fossa Approach and Infratemporal Fossa Approach
16.9 Anterior Atticotomy
16.10 Transmastoid Approaches
16.10.1 Canal Wall Up (Intact Canal Wall) Mastoidectomy
16.10.2 Canal Wall Down Mastoidectomy
16.10.3 Posterior Tympanotomy
16.11 Endolymphatic Sac Decompression
16.12 Subtotal Petrosectomy
16.13 Translabyrinthine Approaches
16.14 Transcochlear Approach
16.15 Presigmoid-Retrolabyrinthine Approach
16.16 Middle Cranial Fossa
16.17 Infratemporal Fossa (IFT) Approach: Type A
16.18 Surgery for Squamous Cell Carcinoma: Temporal Bone Resection
16.19 Endoscopic Ear Surgery
16.19.1 Protympanum
16.19.2 Epitympanum
16.19.3 Retrotympanum
16.19.4 Hypotympanum
16.20 Complications, Challenges, and Prognosis
16.21 Conclusion
References
17: Paediatric Head and Neck Pathology and Surgery
17.1 Introduction
17.2 Common Tumours in Paediatric Patients
17.2.1 Vascular Lesions
17.2.2 Infantile Haemangioma
17.2.2.1 Introduction
17.2.2.2 Epidemiology
17.2.2.3 Pathogenesis
17.2.2.4 Phases
17.2.2.4.1 Proliferative Phase
17.2.2.4.2 Involution Phase
17.2.2.5 Diagnosis
17.2.2.6 Treatment
17.2.2.7 Medical Therapy
17.2.2.8 Laser Therapy
17.2.2.9 Surgical Therapy
17.2.3 Dermoid Cyst
17.2.3.1 Introduction
17.2.3.2 Classification of Aetiology
17.2.3.3 Clinical Presentation
17.2.3.4 Imaging
17.2.3.5 Treatment
17.2.3.5.1 Surgery
17.3 Thyroglossal Duct Cyst
17.3.1 Introduction
17.3.2 Embryology
17.3.3 Clinical Presentation
17.3.4 Diagnosis
17.3.4.1 Blood Investigation
17.3.4.2 Fine Needle Aspiration Cytology (FNAC)
17.3.4.3 Histology
17.3.4.4 Imaging
17.3.5 Treatment
17.3.5.1 Surgery
17.3.5.2 Sclerotherapy
17.4 Rhabdomyosarcoma
17.4.1 Introduction
17.4.2 Epidemiology and Aetiology
17.4.3 General Characteristics
17.4.4 Histology
17.4.5 Diagnosis
17.4.5.1 Biopsy
17.4.6 Staging
17.4.7 Treatment
17.4.7.1 Chemotherapy
17.4.7.2 Radiation Therapy
17.4.7.3 Surgical Therapy
17.4.8 Prognosis
17.4.9 Recurrence
17.5 Juvenile Nasopharyngeal Angiofibroma
17.5.1 Introduction
17.5.2 Epidemiology
17.5.3 Aetiology
17.5.4 Pathogenesis
17.5.5 Presentation
17.5.6 Diagnosis
17.5.7 Imaging
17.5.8 Histology
17.5.9 Staging
17.5.9.1 Fisch Staging
17.5.9.2 Radkowski Staging
17.5.10 Treatment
17.5.10.1 Surgery
17.5.10.2 Outcome
17.5.10.3 Complications
17.5.10.4 Radiotherapy
17.5.10.5 Chemotherapy
17.5.10.6 Hormonal Therapy
17.5.10.7 Spontaneous Regression
17.6 Lymphatic Malformation
17.6.1 Introduction
17.6.2 Genetics
17.6.3 Clinical Presentation
17.6.4 Diagnosis
17.6.5 Treatment
17.6.5.1 Observation
17.6.5.2 Sclerotherapy
17.6.5.3 Surgery
17.6.5.4 Other Modalities
17.6.5.4.1 Novel Agents
17.7 Cystic Hygroma
17.7.1 Surgical Treatment for a Recurrent Cystic Hygroma: Illustration of a Case
17.8 Lymphoma
17.8.1 Hodgkin’s Lymphoma
17.8.2 Non-Hodgkin’s Lymphoma
17.8.3 Clinical Presentation of HL and NHL
17.8.4 Diagnosis
17.8.4.1 Haematology
17.8.4.2 Imaging
17.8.4.3 Surgery
17.8.5 Classification
17.8.6 Treatment of HL
17.8.7 Treatment of NHL
17.8.7.1 Radiation Therapy
17.9 Langerhans Cell Histiocytosis
17.9.1 Epidemiology
17.9.2 Pathogenesis
17.9.3 Clinical Feature
17.9.4 Investigations
17.9.5 Treatment
17.9.5.1 Solitary or Single-System Involvement
17.9.5.2 Multisystem Involvement
17.9.5.3 Induction Chemotherapy
17.9.5.4 Continuation Chemotherapy
17.9.5.5 Post-treatment Follow-Up
17.9.5.6 Relapsed or Refractory Disease
References
18: Miscellaneous Head and Neck Surgery and the Surgical Steps
18.1 Excision of the Brachial Cyst
18.1.1 Case Illustration 1
18.1.2 Surgical Steps
18.2 Case Illustration 2
18.2.1 Voice Prosthesis Insertion During Total Laryngectomy Case
18.3 Stomatoplasty
18.4 Submandibulectomy with Abdominal Fat Graft
18.5 Platysma-Based Rotational Flap
18.5.1 Case Illustration
18.6 Excision of Vagal Schwannoma
18.6.1 Case Illustration
18.7 Deep Lobe Parotidectomy
18.8 Conclusion
References
19: Updates and Controversies in the Management of Head and Neck Malignancy
19.1 Introduction
19.2 Investigations of Head and Neck Malignancy
19.2.1 Cross-Sectional Imaging
19.2.2 Emerging Applications
19.2.3 Imaging of Hypoxia
19.2.4 Evaluation of Tumor Cell Proliferation
19.2.5 Prevention of Neoangiogenesis
19.2.6 PET-MR
19.2.7 Future of Molecular Imaging in HNSCC
19.2.8 Others
19.2.8.1 SPECT
19.2.8.2 Elastography
19.2.8.3 Fluoroscopy
19.2.8.4 Narrowband Imaging
19.2.9 Biochemical Investigations
19.2.10 Imaging Biomarkers
19.3 Surgical Management of HNSCC
19.3.1 Neck Dissection
19.4 Surgery for Laryngeal Carcinoma
19.5 Oral Cavity Cancer (OCSCC)
19.6 Oropharyngeal Cancer (OPSCC)
19.7 Hypopharyngeal Cancer
19.8 Nasopharynx Carcinoma (NPC)
19.9 Nose and Paranasal Sinuses
19.10 Salivary Gland Malignancy
19.10.1 Parotid Tumors
19.11 Intraoperative Facial Nerve Monitoring
19.12 Carcinoma of Unknown Primary (CUP)
19.12.1 Treatment
19.13 Parapharyngeal Space Tumors (PPS)
19.14 Ongoing Controversies in Management of HNSCC
19.14.1 Controversy in Staging System
19.14.2 Diagnostic Controversy
19.14.3 Sentinel Lymph Node Biopsy (SLNB)
19.14.4 Strategy for Advanced Neck Carcinomas
19.14.5 Optimal Resection Margins
19.15 Controversies in Oral Cavity Carcinoma (OCSCC)
19.15.1 Nonsurgical Treatment
19.15.2 HPV in OCSCC
19.16 Controversies in the Management of Oropharynx Cancer (OPSCC)
19.16.1 Treatment Modality Options for Resectable Tumor
19.16.2 Induction Chemotherapy
19.17 Controversies in Laryngeal Carcinoma
19.17.1 Treatment of Primaries in Laryngeal Glottic Carcinoma
19.18 Controversies in Nasopharyngeal Carcinoma (NPC)
19.19 Future Trend of Therapeutic Strategies
19.19.1 Targeted Therapy
19.19.2 Immunotherapy
19.19.3 Cancer Stem Cells (CSCs)
19.20 Conclusion
References