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Head & Neck Surgery (2 Volumes)
Christopher deSouza, Fred Stucker, Gady Har-El, Anil D\'Cruz, Pankaj Chaturvedi, Abir K Bhattacharya, Cherie-Ann O Nathan
SECTION 1: RHINOLOGY
CHAPTER 1:
Anatomy of the Lateral Nasal Wall
BLOOD SUPPLY OF THE LATERAL NASAL WALL
Anterior Ethmoidal Artery
Posterior Ethmoidal Artery
Sphenopalatine Artery
CHAPTER 2:
Physiology of the Nose
AIRFLOW
HUMIDIFICATION
PROTECTION OF THE AIRWAY
Mechanical Protection
NASAL SECRETIONS
Mucus Biochemistry
Mucus Pathophysiology
Ciliary Activity
Immunological Protection
NASAL VASCULATURE AND NERVE SUPPLY
Nasal Autonomic Nervous System
Nasal Sensation
OLFACTION
Olfactory Epithelium
Olfactory Responses
THE NOSE AND THE VOICE
CONCLUSION
CHAPTER 3:
Measurement of Nasal Function and Nasal Valve Surgery
TECHNIQUES
Rhinomanometry
Acoustic Rhinometry
SPIROMETRIC TECHNIQUES
Forced Oscillation
OTHER TECHNIQUES
CONCLUSION
REFERENCES
INTRODUCTION
THE INTERNAL NASAL VALVE
THE EXTERNAL NASAL VALVE
VALVE PATHOLOGY
CLINICAL ASSESSMENT
HISTORY AND EXAMINATION
MANAGEMENT OF NASAL VALVE DEFICIENCY
Internal Valve Surgery
External Nasal Valve Surgery
CONCLUSION
CHAPTER 4:
The Olfactory System and its Disorders
ANATOMY AND PHYSIOLOGY
OLFACTORY DYSFUNCTIONS
Classification and Etiology
Mechanical Obstruction
Inflammatory Processes
Infection
Traumatism
Tumors
Endocrinologic Pathologies
Neurological Diseases
Intoxication
Iatrogenic Disorders
Idiopathic Conditions
INVESTIGATIONS
TREATMENT
CHAPTER 5:
Juvenile Nasopharyngeal Angiofibroma
ETIOPATHOGENESIS—A REVIEW OF LITERATURE
PATHOLOGY
MODE OF SPREAD
CLASSIFICATION
Andrew-Fisch Classification
Radkowsky Classification
MODE OF ADHERENCE
BLOOD SUPPLY
CLINICAL FEATURES
DIAGNOSIS
TREATMENT
Principles of Surgery
Surgical Approaches
Choice of Approach
Differential Diagnosis
Prognosis
Newer Avenues
CONCLUSION
CHAPTER 6:
Congenital Malformations of the Nose and Paranasal Sinuses
EMBRYOLOGY OF THE NOSE, PARANASAL SINUSES AND ANTERIOR SKULL BASE
ENCEPHALOCELES
GLIOMAS
NASAL DERMOIDS
COMPLETE AGENESIS OF THE NOSE
CRANIOFACIAL CLEFTS
MEDIAN NASAL CLEFTS
LATERAL NASAL CLEFTS
PROBOSCIS LATERALIS
POLYRHINIA AND SUPERNUMERARY NOSTRIL
CLEFT LIP NASAL DEFORMITY
CHOANAL ATRESIA
CONGENITAL NASAL PYRIFORM APERTURE STENOSIS (CNPAS)
NASOLACRIMAL DUCT CYSTS
NASOPHARYNGEAL TERATOMAS
CHAPTER 7:
Common Cysts and Tumors of the Jaws
CYSTS OF THE JAWS
ODONTOGENIC CYSTS
Developmental Odontogenic Cysts
Dentigerous Cyst
Eruption Cyst
Lateral Periodontal Cyst
Odontogenic Keratocyst
Nevoid Basal Cell Carcinoma Syndrome
Orthokeratinizing Odontogenic Cyst
Treatment
Glandular Odontogenic Cyst
Treatment
Calcifying Odontogenic Cyst
Treatment
Inflammatory Odontogenic Cysts
Buccal Bifurcation Cyst
Periapical Cyst
Cysts of the Jaws of Nonodontogenic Origin
Nasopalatine Duct Cyst
Nasolabial Cyst
Gingival Cysts of the Adult
Palatal Cysts of the Newborn
Dermoid Cyst
PSEUDOCYSTS OF THE JAWS
Simple Bone Cyst
Treatment
ANEURYSMAL BONE CYST
Treatment
ODONTOGENIC TUMORS
EPITHELIAL ODONTOGENIC TUMORS
Adenomatoid Odontogenic Tumor
Treatment
Squamous Odontogenic Tumor
Treatment
Calcifying Epithelial Odontogenic Tumor (CEOT)b
Treatment
AMELOBLASTOMAc
AMELOBLASTIC CARCINOMA AND MALIGNANT AMELOBLASTOMA
Treatment
Conventional Ameloblastoma
Unicystic Ameloblastoma
Peripheral Ameloblastoma
Recurrent Ameloblastoma
CLEAR CELL ODONTOGENIC CARCINOMA
Treatment
ECTOMESENCHYMAL ODONTOGENIC TUMORSd
Odontogenic Fibroma
Treatment
Cementoblastoma
Treatment
Odontogenic Myxoma
Treatment
MIXED ODONTOGENIC TUMORS
Odontoma
Treatment
Ameloblastic Fibroma
Treatment
NON-ODONTOGENIC TUMORS
Giant Cell Granuloma
Treatment
Treatment
Benign Fibro-osseous Lesions
Treatment
SURGICAL MANAGEMENT OF ODONTOGENIC TUMORS
General Considerations
Basic Surgical Principles
Primary versus Secondary Reconstruction
SURGICAL TREATMENT OF BENIGN MANDIBULAR ODONTOGENIC NEOPLASMS
Continuity Resection
Peripheral Resection
Mandibular Reconstruction
HEALING OF CANCELLOUS CELLULAR MARROW BONE GRAFTS
SURGICAL TREATMENT OF BENIGN MAXILLARY ODONTOGENIC NEOPLASMS
RECENT ADVANCES IN MAXILLOFACIAL RECONSTRUCTION
Distraction Osteogenesis
Inferior Alveolar Nerve Considerations
Nerve Preservation
Bone Growth Factors
Bone and Tissue Engineering
Implant-Supported Prosthodontics
REFERENCES
Textbook
Journal
CHAPTER 8:
Fungal Rhinosinusitis
AGENTS FOR TREATMENT OF INVASIVE FUNGAL INFECTIONS
Amphotericin B Deoxycholate
Lipid based Formulations of Amphotericin B
Core Message
Azoles
Mechanism of Action
Flucytosine
Terbinafine
CHAPTER 9:
Endoscopic Sinus Surgery
ANESTHESIA FOR FESS
GENERAL ASPECTS AND INSTRUMENTATION
INDICATIONS AND CONTRAINDICATIONS
TECHNIQUE OF FUNCTIONAL ENDOSCOPIC SINUS SURGERY
High-risk Areas and Complications
POSTOPERATIVE CARE AND TREATMENT
ACKNOWLEDGMENT
REFERENCES
ANATOMY
PATHOLOGY
DIAGNOSTIC PROCEDURES
Fluorescein Test
Dacryocystography (Fig. 9.10)
Dacryocystogammagraphy
INDICATIONS
SURGICAL TECHNIQUE
ACKNOWLEDGMENT
REFERENCES
INDICATIONS
OPERATIVE TECHNIQUE AND INDICATIONS OF THE ENDONASAL FRONTAL SINUS DRAINAGE ACCORDING TO DRAF
Type I: Simple Drainage
Type II A and B: Extended Drainage
Type III: Endonasal Median Drainage
RESULTS OF ENDONASAL FRONTAL SINUS SURGERY
POSTOPERATIVE CARE
Packing
Local Postoperative Therapy
General Postoperative Medication
COMPLICATIONS
CONCLUSION
REFERENCES
HISTORY
Symptoms of the Present Illness
Past Medical and Surgical History
PHYSICAL EXAMINATION AND ENDOSCOPY
Olfactory Testing
ACOUSTIC RHINOMETRY AND RHINOMANOMETRY
IMAGING
INFORMED PATIENT CONSENT
ACKNOWLEDGMENTS
GENERAL PRINCIPLES
BENIGN TUMORS
Osteoma
Inverted Papilloma (IP)
Juvenile Angiofibroma (JA)
MALIGNANT TUMORS
Squamous Cell Carcinoma (SCC)
Adenocarcinoma (AC)
Esthesioneuroblastoma (ENB)
POSTOPERATIVE MANAGEMENT
Postoperative Course
Follow-up
CONCLUSION
ACKNOWLEDGMENTS
REFERENCES
ORBITAL COMPLICATIONS
Violation of the Orbit with Fat Herniation
Retro-orbital Hemorrhage
Damage of the Medial Rectus Muscle
Optic Nerve Lesion
Bleeding
Sphenopalatine Artery
Ethmoid Arteries
Internal Carotid Artery and Cavernous Sinus
Intracranial Lesions
CSF Leak
Brain Injury
Cranial Nerve Injuries
GENERAL CONSIDERATIONS
ACKNOWLEDGMENT
REFERENCES
WHAT MAKES REVISION SURGERY NECESSARY?
View of the Patient
Analysis of the Surgeon
PRINCIPLES AND TECHNIQUES
Endonasal Revision
External Revision
SPECIFIC FAILURES DEMANDING REVISION SURGERY
Postoperative Frontal Sinusitis after Type I and Type II Drainage
Reclosure after Type III Drainage
FOLLOW-UP
BACKGROUND
REFERENCES
PREOPERATIVE EVALUATION
Surgical Management
ACKNOWLEDGMENTS
REFERENCES
ANATOMY
SURGICAL TECHNIQUE
DIRECT TRANSNASAL ACCESS
TRANSSEPTAL ACCESS
RESECTION OF POSTERIOR NASAL SEPTUM
REFERENCES
INDICATIONS
PREOPERATIVE INVESTIGATIONS
SURGICAL ANATOMY
SURGICAL TECHNIQUE
Endoscopic Optic Nerve Decompression
Endoscopic Orbital Decompression
CONSERVATIVE TREATMENT WITH CORTICOSTEROIDS
Authors’ Results
GENERAL GUIDELINES AND CONCLUSIONS
REFERENCES
HISTORY
SITE OF CSF FISTULAS
DIAGNOSIS
AREAS OF ENDONASAL SKULL BASE ACCESS
GRAFT MATERIALS
SURGICAL TECHNIQUES
IMPORTANT CONSIDERATIONS TO AVOID FAILURES
ACKNOWLEDGMENTS
REFERENCES
ANATOMY
Pituitary Gland
Sella Turcica
Sphenoid Sinus and Sinonasal Anatomy
SURGICAL INDICATIONS
Preoperative Evaluation
Surgical Technique
Postoperative Management
Complications
CONCLUSION
CHAPTER 10:
Endoscopic Transnasal Surgery
CLASSIFICATION
Transnasal Direct Approach
Transethmoidal Approach
Transseptal Approach
Posterior Septal Incision
Transnasal Approach with Removal of the Posterior Part of the Nasal Septum (Bi-nostril Approach)
Transsphenoidal–transplanum Approach
Transsphenoidal–transpterygoidal Approach
Transsphenoidal–transclival Approach
Approach to the Clivus and Cavernous Sinus
Combined Approaches
CHAPTER 11:
Rhinosinusitis
DIAGNOSIS
Major Symptoms
Minor Symptoms
ACUTE (PRESUMED BACTERIAL) RHINOSINUSITIS
CHRONIC RHINOSINUSITIS (CRS)
Physical Findings in CRS
External
Anterior Rhinoscopy
Nasal Endoscopy
RADIOLOGICAL DIAGNOSIS
CT Correlation with CRS Symptoms
Nasal Endoscopy in Correlation with CRS Symptoms
Pathogenesis
Osteitis
Biofilms
Superantigens (SAgs)
The Role of Bacteria in CRS
Medical Management of CRS
NASAL POLYPOSIS
Treatment of Chronic Rhinosinusitis
CRS VERSUS NASAL SEPTAL DEVIATIONS
Complications of Rhinosinusitis
CHAPTER 12:
Evidence-based Management of Pediatric Chronic Rhinosinusitis
EPIDEMIOLOGY OF PEDIATRIC SINUSITIS
DIAGNOSIS OF PEDIATRIC SINUSITIS
Physical Examination
Radiographic Imaging
Medical Therapy
Surgical Therapy
ENDOSCOPIC SINUS SURGERY
Surgical Considerations
Facial Growth
Evaluating the Evidence
Recommendations
Medical History and Physical Examination
Radiographic Imaging
Medical Therapy
Surgical Therapy
SUMMARY
CHAPTER 13:
Nasal Polyposis: Current Concepts in Pathophysiology and Management
EPIDEMIOLOGY
CLASSIFICATION
PATHOPHYSIOLOGY
Allergic Inflammation
Non-allergic Inflammation
HISTOLOGY
ANATOMICAL OCCURRENCE
DIAGNOSIS
Clinical Presentation and Evaluation
Radiographic Appearance
MEDICAL MANAGEMENT
Systemic Corticosteroids
Intranasal Steroids
Antibiotic Therapy
Antifungal Therapy
Leukotriene Modifiers
Intranasal Capsaicin
Antihistamines
Intranasal Lysine-acetylsalicylic Acid (LAS)
Intranasal Furosemide
SURGICAL MANAGEMENT
Surgery
SPECIAL CONSIDERATIONS
Aspirin-sensitive Patients
Allergic Fungal Sinusitis
Cystic Fibrosis
Antrochoanal Polyp
ACKNOWLEDGMENTS
CHAPTER 14:
Transsphenoidal Approaches to the Sella Turcica
SURGICAL APPROACHES
Sublabial Transsphenoidal Approach
Transnasal Transsphenoidal Approach
Endoscopic Transsphenoidal Approach
Image-guided Surgery
Complications
CONCLUSION
CHAPTER 15:
Cerebrospinal Fluid Leak
NORMAL PHYSIOLOGY
PATHOPHYSIOLOGY
DIAGNOSIS (FIGS 15.1 TO 15.4)
Treatment (Figs 15.5 to 15.10)
CHAPTER 16:
Optic Nerve Decompression
ANATOMY/MECHANISMS OF INJURY
DIAGNOSIS
TREATMENT
SURGICAL APPROACHES
CONCLUSION
CHAPTER 17:
Midfacial Degloving Approach to the Nose, Sinuses, and Skull Base
SURGICAL TECHNIQUE
COMPLICATIONS
CHAPTER 18:
Robotics in Otolaryngology
ROBOTIC SURGERY
Telerobotic Surgery
Telerobotic Video Assistance
Telepresence Robotic Surgery
Telementoring
Advantages and Disadvantages of a Robotic System
ROBOTIC APPLICATION IN OTOLARYNGOLOGY
CONCLUSION
CHAPTER 19:
Image-guided Endoscopic Sinus Surgery
HISTORICAL PERSPECTIVE
OVERVIEW OF CURRENT TECHNOLOGY
System Components
Computer Workstation
Display Monitor
Localization System
Surgical Instrumentation
Data Storage and Transfer
THE REGISTRATION PROCESS
Anatomic Fiducial Registration
Skin-affixed Fiducials
Bone-anchored Fiducial Registration
Autoregistration
Surface Mapping Registration
ISSUES RELATED TO ACCURACY
CURRENT USE AND CONCERNS
INDICATIONS FOR IMAGE-GUIDED SINUS SURGERY
Revision Sinus Surgery
Sphenoid and Posterior Ethmoid Surgery
Frontal Sinus Surgery
Extended Endoscopic Applications
BALANCING COSTS AND BENEFITS
STANDARD OF CARE
NEW APPLICATIONS AND FUTURE CONSIDERATIONS
SUMMARY
ACKNOWLEDGMENT
Financial Disclosures
CHAPTER 20:
Powered Instrumentation in Endoscopic Sinus Surgery
ENGINEERING AND DESIGN CONSIDERATIONS
APPLICATION OF POWERED INSTRUMENTATION
Polypectomy
Maxillary Antrostomy and Sphenoethmoidectomy
Inferior Turbinate Reduction
Frontal Sinus Surgery
Orbital Surgery
Endoscopic Surgery of the Skull Base
Endoscopic Removal of Neoplasms
USE OF POWERED INSTRUMENTATION WITH IMAGE-GUIDED SURGERY
COMPLICATIONS
Orbital Injury
CSF Leaks
Tissue Effects and Outcomes
FUTURE DIRECTIONS
Financial Disclosures
CHAPTER 21:
Minimally Invasive Sinus Surgery
THEORETICAL CONCERNS
THE MIST PROTOCOL
Preoperative Protocols
Intraoperative Protocols
Postoperative Protocols
OUTCOME STUDIES INVOLVING MIST
THE FESS DEPARTURE FROM FUNCTIONAL PRINCIPLES
CHAPTER 22:
Epistaxis
EPIDEMIOLOGY
ETIOLOGY
Local Causes
Systemic Causes
MANAGEMENT
Chronic or Recurrent Epistaxis
Acute Epistaxis
Packing
Invasive Procedures
SUMMARY
CHAPTER 23:
Disorders of the Nasal Septum
SEPTAL DEVIATION
SEPTAL PERFORATION
Iatrogenic
Traumatic
Drug-induced
INFECTIONS
INFLAMMATORY DISEASES
WEGENER'S GRANULOMATOSIS
Sarcoidosis
Angiocentric T-cell Lymphoma
SEPTAL NEOPLASMS
REACTIVE SEPTAL LESIONS
SUMMARY
CHAPTER 24:
Nasal Allergy: Diagnosis, Evaluation and Management
PATHOPHYSIOLOGY OF ALLERGIC RHINITIS
Type I: Immediate Hypersensitivity
Type II: Antibody-mediated Cytotoxicity
Type III: Immune Complex-mediated
Type IV: Cell-mediated Hypersensitivity
RHINOSINUSITIS AND ALLERGY
Diagnosis
History
Physical Examination
TREATMENT OF ALLERGIC RHINITIS
Allergen Avoidance
Pharmacotherapy
Antihistamines
Corticosteroids
Mast Cell Stabilizers
Anticholinergics
Decongestants
Allergy Testing
In Vivo Testing
In Vitro Testing
Immunotherapy
FOOD ALLERGY
ALLERGIC FUNGAL SINUSITIS
ANAPHYLAXIS
SUMMARY
CHAPTER 25:
Surgery of the Frontal Sinus
ANATOMY
The Frontal Recess
Physiology
ADVANCES IN ENDOSCOPIC SINUS SURGERY
Functional Endoscopic Sinus Surgery (FESS) Paradigm
Image-guided FESS Paradigm
Frontal Instrumentation
Indications
Contraindications
Advantages
Disadvantages
Surgical Techniques
Outcomes
Indications
Contraindications
Advantages
Disadvantages
Outcomes
Indications
Contraindications
Advantages
Disadvantages
Surgical Technique
Outcomes
Indications
Relative Contraindications
Advantages
Disadvantages
Surgical Technique
Outcomes
Indications
Surgical Technique
Indications
Contraindications
Advantage
Disadvantages
Surgical Technique
Outcomes
CONCLUSION
CHAPTER 26:
Granulomatous Diseases of the Nose and Paranasal Sinuses
DEFINITION
CATEGORIES
INFLAMMATORY DISEASES
Wegener's Granulomatosis
Definition
Epidemiology
Prognosis
Etiology
General Clinical Evaluation
Systemic Manifestations
Head and Neck Manifestations
Nasal and Sinus Manifestations
Clinical Evaluation of Sinonasal WG
Acute Vasculitic Sinonasal WG
Symptoms and Management
Long-term Sequelae and their Treatment
Sarcoidosis
Epidemiology
Etiology
General Clinical Evaluation
Systemic Manifestations
Treatment
Head and Neck Manifestations
Nasal and Sinus Manifestations
Clinical Evaluation
Management
Churg-Strauss Syndrome
Definition
Head and Neck Manifestations
General Clinical Evaluation
Sinonasal CSS Evaluation
Treatment
Cholesterol Granuloma
NEOPLASTIC DISEASES
Sinonasal T-cell Lymphoma (Midline Lethal Granuloma)
History and Definition
Epidemiology
Clinical Presentation
Clinical Evaluation
Treatment
INFECTIOUS DISEASES
Mycobacteria
Rhinoscleroma
Syphilis
Actinomycosis
Rhinosporidosis
Fungi
Blastomycosis
Histoplasmosis
Invasive Granulomatous Fungal Sinusitis
Parasites
Leishmaniasis
CONCLUSION
CHAPTER 27:
Imaging of the Paranasal Sinuses
ANATOMY OF THE NASAL CAVITY AND PARANASAL SINUSES
The Nose and Nasal Fossae
The Paranasal Sinuses
Frontal Sinus
Ethmoidal Sinus
Maxillary Antrum
Sphenoid Sinus
Normal Mucociliary Clearance and the Osteomeatal Channels
PARANASAL SINUS DEVELOPMENT
Anatomic Variations
Concha Bullosa
Nasal Septum Deviation
Paradoxical Middle Turbinate
Variations in the Uncinate Process
Haller Cells
Onodi Cells
Giant Ethmoid Bulla
Extensive Pneumatization of the Sphenoid Sinus
Medial Deviation or Dehiscence of the Lamina Papyracea
Low-lying Fovea Ethmoidalis
IMAGING TECHNIQUES
Sinonasal Disease
Congenital Disease
Sinonasal Inflammatory Disease
Sinonasal Polyposis
Fungal Sinusitis
Local Mucosal Complications of Sinusitis
Regional Complications of Acute Sinusitis
Noninfectious Destructive Sinonasal Disease
Tumors
Angiofibroma
Papilloma
Squamous Cell Carcinoma
Adenocarcinoma
Adenoid Cystic Carcinoma
Mucoepidermoid Carcinoma
Esthesioneuroblastoma
Malignant Melanoma
Rhabdomyosarcoma
Lymphoma
Chondrosarcoma
Osteosarcoma
Giant Cell Tumors
Fibro-osseous Lesions
Osteomas
Odontogenic Cysts
Odontogenic Tumors
Metastases to the Paranasal Sinuses
ACKNOWLEDGMENT
CHAPTER 28:
The Subcranial Approach to the Anterior Skull Base
PREOPERATIVE EVALUATION AND ANESTHESIA
THE SURGICAL TECHNIQUE OF THE SUBCRANIAL APPROACH
COMBINATIONS OF THE SUBCRANIAL APPROACH
RECONSTRUCTION FOLLOWING SUBCRANIAL SURGERY
POSTSURGICAL TREATMENT
Surgical Results
USE OF THE SUBCRANIAL APPROACH IN THE PEDIATRIC PATIENT
POSTOPERATIVE CONTROL OF ACUTE PAIN FOLLOWING SUBCRANIAL EXTIRPATIONS
CYTOGENETIC ANALYSIS OF SKULL BASE TUMORS
Cytogenetic Results
Clinical Relevance
QUALITY OF LIFE FOLLOWING SUBCRANIAL SURGERY FOR ANTERIOR SKULL BASE TUMORS
CONCLUSION
CHAPTER 29:
Benign Tumors of the Nasal Cavity and Nasopharynx
BENIGN TUMORS OF THE NASAL CAVITY
History
Clinical Examination
Special Investigation
Classification
EPITHELIAL TUMORS
Papillomas
Inverted Papilloma
Squamous Cell Papilloma
Adenomas
Papillary Adenoma (Cylindric Papilloma)
Minor Salivary Gland Tumors (Pleomorphic Adenoma)
NON-EPITHELIAL TUMORS
Fibroma
Hemangioma
Capillary Hemangioma
Cavernous Hemangioma
Benign Neoplasms Arising from Nervous Tissue
Gliomas and Encephaloceles
Meningioma
Neurilemmoma
Chondroma
Osteoma
Leiomyoma
TUMORS OF THE NASOPHARYNX
Juvenile Nasopharyngeal Angiofibroma
Etiology
Origin
Background
Histology
Physical Characteristics
Routes of Spread
Recurrence
Clinical Features
Diagnosis
Radiology
Staging
Treatment
CHAPTER 30:
Microbiology and Medical Management of Bacterial Sinusitis
MICROBIOLOGY OF ACUTE SINUSITIS
MICROBIOLOGY OF CHRONIC SINUSITIS
Discrepancies in the Recovery of Bacteria from Multiple Sinuses
Bacteria in Acute Exacerbation of Chronic Sinusitis
MICROBIOLOGY OF NOSOCOMIAL RHINOSINUSITIS
ANTIMICROBIAL MANAGEMENT
Antimicrobial Resistance
S. Pneumoniae Resistance
Antimicrobial Agents
PRINCIPLES OF ANTIMICROBIAL THERAPY
Antimicrobial Therapy of Acute Sinusitis
Antimicrobial Therapy of Chronic Sinusitis
ADJUVANT THERAPIES
Acute Bacterial Sinusitis
Chronic Bacterial Sinusitis
CHAPTER 31:
Headache and Facial Pain
CLASSIFICATION OF HEADACHE AND FACIAL PAIN
Abbreviated Classification of Headache
Migraine
Tension-type headache
Cluster headache and other trigeminal-autonomic cephalgias
Headache attributed to
Facial Pain
Peripheral Causes
Disorders of the Sinonasal Complex
Central Causes
Primary (Idiopathic)
Secondary
MIGRAINE
Symptoms of Migraine
Migraine without Aura (Common migraine)
Migraine with Aura (Classic migraine)
Migraine Triggers
Management of Migraine
Abortive Treatment
Preventive Treatment
Causes of Pain in the Head and Face
Viral Cranial Neuropathy
Relapsing Polychondritis
THE EYE AND HEADACHES
Cranial Neuralgias and Headaches Associated with Cranial Vascular Disorders
Trigeminal Neuralgia
Glossopharyngeal Neuralgia
Geniculate Neuralgia (Nervus Intermedius Neuralgia of Hunt)
Occipital Neuralgia
Atypical Facial Pain
Headaches in Strokes and Cerebrovascular Accidents
Subarachnoid Hemorrhage (SAH)
Benign Thunderclap Headache (BTH)
Cerebral Venous Thrombosis
Carotid and Vertebral Artery Dissection
Temporal Arteritis (Giant Cell Arteritis)
Pharmacological Management of Head and Neck Pain
Nonopioids
Opioids
Adjunctive Therapy
FACIAL PAIN
Craniomandibular Disorders
The Myofacial Pain Syndrome
Internal Derangement of the Temporomandibular Joint
Neoplastic Causes of Facial Pain
Sinonasal Facial Pain
Patient Management
Regional Anesthesia Therapy
SECTION 2: FACIAL PLASTICS
CHAPTER 32:
Forehead Rejuvenation
FOREHEAD ANATOMY
Scalp and Forehead Musculature
Fascia
Sensory and Motor Nerves in the Forehead
AESTHETIC EVALUATION OF THE FOREHEAD
PATIENT SELECTION
SELECTION OF BROWLIFT TECHNIQUE
Endoscopic Browlift: Surgical Technique
Surgical Dissection
BROW FIXATION
TRICHOPHYTIC BROWLIFT IN THE HAIRLINE
BOTOX FOREHEAD REJUVENATION
Complications
CONCLUSION
CHAPTER 33:
Mandible Fractures
EVALUATION
Examination
Radiologic Assessment
Time Until Treatment
TREATMENT
MAXILLOMANDIBULAR FIXATION
Technique of Fixation
Approach
Fracture Reduction
Fixation
Compression Synthesis Versus Non-compression Synthesis
Postoperative Maxillomandibular Fixation
Postoperative Care
Antibiotics
Experience
Complications
Paresthesias
Wound Dehiscence/Exposed Plates
Malocclusion
Controversies
Stress Shielding
Teeth in Line of Fracture
SUBCONDYLAR/CONDYLAR FRACTURES
EDENTULOUS MANDIBLE FRACTURES
INFECTED OR COMMINUTED FRACTURES
Fractures at the Angle
Rigid versus Non-rigid Techniques
Approach and Choice of Plate
Compression and Angle Fractures
COMPLICATIONS IN ANGLE FRACTURES
Infection
ADVANCES IN SURGICAL TECHNIQUES
Maxillomandibular Fixation Screws
Endoscopic Approach to the Subcondylar Fracture
Resorbable Plates
Locking Screws
Summary
ACKNOWLEDGMENT
CHAPTER 34:
Asian Rhinoplasty
ANATOMY
SILICONE NASAL AUGMENTATION
Surgical Technique
ADJUNCTIVE PROCEDURES
Postoperative Care
Complications
SUMMARY
CHAPTER 35:
Asian Blepharoplasty
TECHNIQUES
DEBULKING
CHAPTER 36:
The Use of Botulinum Toxin in the Head and Neck
HISTORY OF CLOSTRIDIUM BOTULINUM
DEFINING BOTULINUM TOXIN
MECHANISM OF ACTION
SAFETY AND ANTIGENICITY
RECONSTITUTION
COSMETIC USES
Glabella BTX
Forehead
Crow's Feet
Treatment of the Lower Third of the Face
SPASMODIC DYSPHONIA
ESOPHAGEAL DISORDERS
FACIAL DYSTONIAS
HEADACHE
FREY'S SYNDROME
HYPERHIDROSIS
CHAPTER 37:
Transconjunctival Lower Lid Blepharoplasty
SURGICAL ANATOMY OF THE LOWER LID
PATIENT SELECTION
SURGICAL TECHNIQUE
COMPLICATIONS
CONCLUSION
CHAPTER 38:
Facial Contouring—Malar and Chin Augmentation
ANALYSIS
IMPLANTS
Alloplastic Implants
Implant Materials
Non-carbon-based Polymers
Carbon-based Polymers
Calcium Phosphate Ceramics
AUTOGENOUS GRAFTS
OSTEOTOMY
Malar Augmentation
Relevant Anatomy
Alloplastic Implant Placement
Malar Osteotomy
Chin Augmentation
Relevant Anatomy
Alloplastic Augmentation
SLIDING GENIOPLASTY
CONCLUSION
ACKNOWLEDGMENT
CHAPTER 39:
Otoplasty
ANATOMY
External Ear
Ligaments and Muscles
Nerves
Vascular Supply
EMBRYOLOGY
PREOPERATIVE EVALUATION
SURGICAL INDICATION
SURGICAL TECHNIQUE
Combined Technique
Results
Advantages of the Combined Technique
COMPLICATIONS
Early Complications
Late Complications
Summary
CHAPTER 40:
Local Flaps in Facial, Head and Neck Surgery
PHYSIOLOGY
PATIENT SELECTION/PREOPERATIVE EVALUATION
TREATMENT PLANNING
SURGICAL PREPARATION
INCISION PLACEMENT
CLASSIFICATION
ADVANCEMENT FLAPS
Simple Advancement
Rectangular Advancement
T-plasty
V-Y Advancement
Island Advancement
ROTATION FLAPS
O-Z Plasty
TRANSPOSITION FLAPS
Z-plasty
Rhombic Transposition Flap
Bilobed Flap
Melolabial Flaps
Paramedian Forehead Flaps
Dorsal Nasal Flaps
DEFECT BASED APPROACH TO RECONSTRUCTION
Scalp Defects
FOREHEAD AND TEMPLE DEFECTS
Midline Forehead
Paramedian Forehead
Lateral Forehead
Eyebrow
Temple
AURICULAR DEFECTS
Conchal Bowl and Helix
Upper Third
Middle Third
Lower Third
EYELID DEFECTS
Periorbital Skin
Partial Thickness Defects
Full Thickness Defects
NASAL DEFECTS
Alar Subunit
Columellar Subunit
Tip Subunit
Nasal Ala and Sidewall Subunits
CHEEK DEFECTS
Medial Subunit
Buccal Subunit
Zygomatic Subunit
Lateral Subunit
LIP DEFECTS
Upper Lip
Lower Lip
OTHER DEFECTS
CONCLUSION
CHAPTER 41:
The Nasal Tip
AESTHETIC ANALYSIS
STRUCTURAL ANALYSIS OF THE NASAL TIP
Incisions and Approaches
SURGICAL TECHNIQUES
Tip Narrowing/Refinement
Volume Reduction
Reorientation
Augmentation
Soft Tissue Debulking
Tip Projection
Increase in Tip Projection
Decrease in Tip Projection
Tip Rotation
Increase in Tip Rotation
Decrease in Tip Rotation
Complications
Summary
Representative Cases
CHAPTER 42:
Open (External) Septorhinoplasty Approach
INDICATIONS
CONTRAINDICATIONS
PREOPERATIVE ASSESSMENT
INTRAOPERATIVE TECHNIQUE
Anesthesia
Surgical technique
Incision and Exposure
Septoplasty
Closing the Septoplasty
Inferior Turbinate Outfracture
Nasal Base
Specific Techniques for Lobule Reconstruction
Nasal Dorsum
Closure
Alar Base Reduction
POSTOPERATIVE MANAGEMENT
RESULTS
Advantages
Disadvantages
CHAPTER 43:
Soft Tissue Fillers of the Face and Liposuction of the Face and Neck
THE PERFECT MATERIAL
History
International Scenario
NON-HUMAN BIOLOGIC MATERIALS
Autologous Tissue
Allografts
NONBIOLOGIC MATERIALS
Silicone
Polyethylene (HDPE)
Other Materials
Risks
TECHNIQUE FOR INJECTABLE IMPLANTS
Anatomic Considerations
Forehead, Glabellar and Forehead Lines
Nose
Cheek
Nasolabial Folds
Lips, Marionette Lines
Temporary Options
Permanent Options
Risks
Chin Augmentation
LIPOSUCTION OF THE HEAD AND NECK
SURGICAL TECHNIQUES
Cervical Liposuction
Complications
CHAPTER 44:
Oromandibular Reconstruction
PRINCIPLES OF MANDIBULAR RECONSTRUCTION
Defect Classification
Bony Classification
The Symphysis
The Body
The Ramus
The Condyle
Soft Tissue Reconstruction
RECONSTRUCTIVE TECHNIQUE
Alloplast
Bone Grafts
Autogenous Bone Grafts
Particulate Cancellous Bone and Marrow Grafts
Vascularized Bone Grafts
Microvascular Flaps
SENSORY RESTORATION
New Frontiers
CONCLUSION
CHAPTER 45:
Reconstruction of Facial Mohs Defects
TREATMENT OF SKIN CANCER
MOHS SURGERY
Mohs Technique
Risk of Recurrence
CONSIDERATIONS IN RECONSTRUCTION
Timing of Reconstruction
Cutaneous Anatomy
Patient Factors
PRINCIPLES OF RECONSTRUCTION
Favorable Tension Lines
Unit/Subunit Principle
Planning
Symmetry
Technique
Postoperative Care
OPTIONS IN RECONSTRUCTION
Healing by Secondary Intention
Primary Closure
Skin Grafts
Split-thickness Skin Grafts
Full-thickness Skin Grafts
Composite Grafts
LOCAL FLAPS
Classification
Pivotal Flaps
Advancement Flaps
Hinge Flaps
RECONSTRUCTION BY SITE
Scalp
Forehead/Brows
Eyelids/Periorbital Region
Cheek
Temple
Chin
Lip
The Cervical Region
Nose
Ear
REVISION PROCEDURES
CONCLUSIONS
SECTION 3: ONCOLOGY
CHAPTER 46:
History and Evolution of Head and Neck Oncology
BLOOD TRANSFUSION
Pathology
SURGERY OF THE SKULL BASE
TREATMENT OF CANCER IN THE NECK
CANCER OF THE EAR
CHAPTER 47:
Epidemiology in Head and Neck Cancers
UADT VERSUS LUNG CANCER
Regionwise Burden of Disease
Regionwise Estimated Incidence
GLOBAL OVERVIEW OF ETIOLOGY OF UADT
Smoking
Smokeless Tobacco
Alcohol
Arecanut
Other Risk Factors
Global Time Trends
High-risk Age Groups
FOCUS ON ASIA
Time Trends in Asia
Immigrant Asian Populations
Mortality in Asia
Incidence in Asia
ETIOLOGY IN ASIA
Lifestyle Factors in Asia
Prevalence of Tobacco Use
Risks Associated with Tobacco, Areca Nut and Alcohol
Cigarette Smoking
PRIMARY PREVENTION OF ORAL CANCER
SECONDARY PREVENTION OF ORAL CANCER
Population Screening Studies
Other Approaches to Population Screening
Periodic Re-examination of Patients with Precancers
Second Primary Cancers
CHAPTER 48:
Etiology of Head and Neck Cancers
MOLECULAR BASIS OF TUMOR DEVELOPMENT
GENETIC PREDISPOSITION
ENVIRONMENTAL FACTORS
Chemical Carcinogens
Tobacco
Mechanism of Action
Alcohol
Betel Quid
Marijuana
Occupational Exposures of Marijuana
Gastroesophageal Reflux
Dietary Factors
Viral Oncogenesis
Epstein-Barr Virus
Human Papilloma Virus
Human Immunodeficiency Virus
Human Herpes Virus 8
Radiation
Ionizing Radiation
Sun Exposure
SUMMARY
CHAPTER 49:
Basic Research in Head and Neck Cancers
GENETIC BASIS OF CANCER
Chromosomes
Molecular Cytogenetics
Genes
P53
EGFR, TGF-α
Genetic Pathways
Tumor Heterogeneity
Clonality
BARRIERS TO TREATMENT OF HNSCC
IDENTIFYING INDIVIDUAL GENES ALTERED IN HNSCC
TRANSLATIONAL RESEARCH IN HNSCC
CONCLUSION
CHAPTER 50:
Pathology
INTRODUCTION
NORMAL SALIVARY GLAND
BENIGN SALIVARY GLAND TUMORS
Overview
Benign Mixed Tumor/Pleomorphic Adenoma
Warthin's Tumor (WT)
Basal Cell Adenoma (BCA)
Canalicular Adenoma
Myoepithelioma
Oncocytoma and Other Oncocytic Lesions
Cystadenoma
MALIGNANT SALIVARY GLAND TUMORS
Mucoepidermoid Carcinoma
Acinic Cell Carcinoma
Adenoid Cystic Carcinoma
Polymorphous Low Grade Adenocarcinoma (Terminal Duct Carcinoma)
Epimyoepithelial Carcinoma
Salivary Duct Carcinoma
Adenocarcinoma, Not Otherwise Specified
Benign Metastasizing Mixed Tumor (BMMT)
Carcinoma Ex-mixed Tumor
Carcinosarcoma/True Malignant Mixed Tumor
Basal Cell Adenocarcinoma
Myoepithelial Carcinoma
Cystadenocarcinomas
Undifferentiated Carcinoma
Clear Cell Carcinoma, Not Otherwise Specified
Oncocytic Carcinoma
OTHER EPITHELIAL TUMORS OF SALIVARY GLAND
MESENCHYMAL TUMORS
Lymphomas
Metastases to Salivary Gland
Fine Needle Aspiration of Salivary Gland
REFERENCES
INTRODUCTION
INTRAEPITHELIAL NEOPLASIA
Squamous Hyperplasia
Squamous Dysplasia
Invasive Carcinoma
Vascular and Perineural Invasion
Squamous Carcinoma Subtypes
Nasopharyngeal Carcinoma
REFERENCES
INTRODUCTION
NORMAL THYROID
BENIGN THYROID NEOPLASMS
Follicular Adenoma
WELL-DIFFERENTIATED THYROID CARCINOMAS
Follicular Carcinoma
Papillary Thyroid Carcinoma
Medullary Thyroid Carcinoma
POORLY DIFFERENTIATED THYROID CARCINOMAS
Insular Carcinoma
UNDIFFERENTIATED THYROID CARCINOMAS
Anaplastic Thyroid Carcinoma
ONCOCYTIC/HURTHLE CELL TUMORS OF THYROID
Follicular Oncocytic Tumors
Papillary Oncocytic Tumors
NON-NEOPLASTIC THYROID TUMORS
Multinodular Goiter (Adenomatous Hyperplasia, Nodular Hyperplasia, Colloid Nodule)
Hashimoto's Thyroiditis
OTHER NEOPLASMS OF THYROID
Lymphoma
Metastases
SPECIAL CONSIDERATIONS
Fine Needle Aspiration Biopsy of the Thyroid Gland
Frozen Section Evaluation of the Thyroid Gland
REFERENCES
CHAPTER 51:
Imaging for Diagnosis and Evaluation
COMMON IMAGING MODALITIES
Ultrasound
Major Advantages of Ultrasound
Major Disadvantages of Ultrasound
Imaging Technique
MAGNETIC RESONANCE IMAGING (MRI)
Imaging Technique
COMPUTED TOMOGRAPHY
Imaging Technique
POSITRON EMISSION TOMOGRAPHY
RADIOLOGICAL EVALUATION OF HEAD AND NECK CANCER
CERVICAL LYMPH NODE INVOLVEMENT
Evaluation of Metastatic Lymphadenopathy by Ultrasound
Size
Shape
Presence or Absence of Echogenic Hilus
Echogenicity
Intranodal Necrosis
Extracapsular Spread
Doppler Color Flow Pattern
Calcification
Evaluation of Metastatic Lymphadenopathy by CT/MRI
Size
Nodal Necrosis
Extracapsular Tumor Spread
Detection of Distant Metastases
Detection of a Second Primary in Head and Neck Region
Pre-treatment Radiological Parameters as Prognostic Markers
SITE-SPECIFIC IMAGING OF COMMON HEAD AND NECK CANCERS
Cancer of the Nasopharynx
Imaging Local Tumor
Imaging Nodal Metastases
Imaging Metastatic Disease
Imaging Residual or Recurrent Tumor
Cancer of Oral Cavity and Oropharynx
Cancer of Oral Cavity
Cancer of Oropharynx
Cancer of Larynx and Hypopharynx
Cancer of Larynx
Cancer of Hypopharynx
Salivary Gland Cancer
Imaging Features of Malignant Tumors
Imaging of Recurrent Tumor
Thyroid Cancers
Imaging Local Tumor
Imaging of Recurrent Disease
Sinonasal Malignancy
RECENT TECHNOLOGICAL ADVANCES
CONCLUSION
CHAPTER 52:
Positron Emission Tomography
POSITRON EMISSION TOMOGRAPHY
THYROID CANCER
Iodine-124
18F-fluorodeoxyglucose
STAGING HEAD AND NECK CANCERS
ASSESSMENT OF RESPONSE AND FOLLOW-UP
ASSESSMENT OF HYPOXIA
Other PET Imaging Tracers
CONCLUSION
ACKNOWLEDGMENT
BIBLIOGRAPHY
Book
Papers
Review Articles
Papers
HEAD AND NECK CANCER FOLLOW-UP EVALUATION
Review Articles
Papers
Review Article
Papers
CHAPTER 53:
Diagnosis and Management of Oral Pre-Cancers
ORAL CARCINOGENESIS PROGRESSION MODEL
Oral Premalignant Lesions
Leukoplakia and Erythroplakia
SUBMUCOUS FIBROSIS
MALIGNANT TRANSFORMATION
DIAGNOSIS AND DETECTION OF ORAL PREMALIGNANT LESIONS
MANAGEMENT OF ORAL PREMALIGNANT LESIONS
CHAPTER 54:
Smoking Cessation
PHYSICIAN ADVICE FOR SMOKING CESSATION
PHARMACOLOGICAL METHODS
WORKPLACE INTERVENTIONS FOR SMOKING CESSATION
TELEPHONE COUNSELING FOR SMOKING CESSATION
INDIVIDUAL BEHAVIORAL COUNSELING FOR SMOKING CESSATION
GROUP BEHAVIOR VERSUS SELF-HELP PROGRAM
PREOPERATIVE INTERVENTIONS FOR SMOKING CESSATION
ALTERNATIVE METHODS USED IN SMOKING CESSATION
SMOKING CESSATION IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE
EXERCISE INTERVENTIONS FOR SMOKING CESSATION
TREATMENT IS EFFECTIVE
RANKING THE VARIOUS CESSATION STRATEGIES
CHAPTER 55:
Chemoprevention of Head and Neck Cancers
HISTORICAL DEVELOPMENTS
New Paradigm for Prevention Trial Design
Target Population
Agent Selection
Endpoints
NEW TARGETS FOR PREVENTION OF HNSCC: COX-2 AND EGFR
SMOKING CESSATION
PRACTICAL CLINICAL PREVENTION
CHAPTER 56:
Radiotherapy in Head and Neck Cancers
LARYNX
Glottic Larynx
Stage T1–T2
Stage T3–Favorable T4
Supraglottic Larynx
HYPOPHARYNX
Pyriform Sinus
Pharyngeal Wall
POSTOPERATIVE IRRADIATION OF LARYNGEAL AND HYPOPHARYNGEAL TUMORS
OROPHARYNX
Base of Tongue
Tonsillar Area
Soft Palate
NASOPHARYNX
ORAL CAVITY
Lip
Floor of the Mouth
Oral Tongue
POSTOPERATIVE IRRADIATION FOR TUMORS OF THE ORAL CAVITY AND OROPHARYNX
NASAL CAVITY, PARANASAL SINUSES AND NASAL VESTIBULE
MAJOR SALIVARY GLANDS
Parotid Gland
Submandibular Gland
Outcomes
UNKNOWN PRIMARY
DESIGN OF THE LOW-NECK PORTAL
Oropharynx, Nasopharynx and Oral Cavity Cancers
Larynx and Hypopharynx Cancers
BOOST TECHNIQUE FOR LARGE OR FIXED LYMPH NODES
CHAPTER 57:
Chemotherapy in Head and Neck Cancers
PHARMACOLOGICAL BASIS OF CHEMOTHERAPY
Antimetabolites
Platinum Compounds
Anthracyclines
Plant Alkaloids
Taxoids
Targeted Agents
TRIAL ENDPOINTS AND DEFINITIONS
Active Agents
CHEMOTHERAPY IN METASTATIC OR RECURRENT DISEASE
TREATMENT OF LOCALLY ADVANCED DISEASE
POSTOPERATIVE ADJUVANT CHEMORADIOTHERAPY
ORGAN PRESERVATION AND INDUCTION CHEMOTHERAPY
TREATMENT OF PRIMARILY INOPERABLE TUMORS
CONCOMITANT DEFINITIVE CHEMORADIOTHERAPY
New Drugs
NASOPHARYNGEAL CARCINOMA
CHEMOTHERAPY AND RARE TUMORS
CHAPTER 58:
Combining Chemotherapy with Radiotherapy in Advanced Squamous Cell Carcinoma
INDUCTION (NEOADJUVANT) CHEMOTHERAPY
ALTERNATING CHEMOTHERAPY AND RADIATION
CONCURRENT CHEMORADIOTHERAPY
POSTOPERATIVE ADJUVANT CHEMORADIOTHERAPY
TREATMENT MORBIDITY
ORGAN PRESERVATION APPROACHES
OUTLOOK FOR THE FUTURE
CONCLUSION
CHAPTER 59:
Immunology and Immunotherapy
PRINCIPLES OF IMMUNOTHERAPY
Types of Immune Response to Tumor
IMMUNE THERAPEUTIC STRATEGIES
Historical Perspective
Antigen-specific Cytotoxic T Lymphocytes
Dendritic Cells
Activated T Cells
Anti-CD3/Anti-CD28 Co-activated T Cells (COACTS)
Arming of T Cells with Bispecific Antibodies
DNA Vaccines
Peptide Vaccines
IMMUNOLOGY OF HNSCC
Locoregional Immune Dysfunction in Head and Neck Cancer
Systemic Immune Deviation in Head and Neck Cancer
Causes of Immunosuppression
Nutrition
Tumor-derived Suppressive Factors
Regulatory Cells
Clinical Implications of Suppressed Immune Function
IMMUNOTHERAPY IN HEAD AND NECK CANCER
Types of Immunotherapy
History of Immunotherapy in HNSCC
Non-specific Immune Stimulants
Retinoids and Prostaglandin Inhibitors
Anti-cancer Antibodies
Adoptive Immunotherapy
Current Immunotherapeutic Trials in HNSCC
OUTLOOK FOR IMMUNOTHERAPY IN HNSCC
CONCLUSION
CHAPTER 60:
Novel Therapies in Head and Neck Cancers
GROWTH FACTORS AND THEIR RECEPTORS
Epidermal Growth Factor Receptor
Cetuximab
Gefitinib
Erlotinib
Other Agents
VASCULAR ENDOTHELIAL GROWTH FACTOR
Combination Agents and Combinations of Agents
HEPATOCYTE GROWTH FACTOR
SIGNAL TRANSDUCTION
RAS INHIBITORS
RAF INHIBITORS
mTOR INHIBITORS
PROTEIN KINASE C (PKC) INHIBITORS
CELL CYCLE INHIBITORS
TARGETING p53
PROTEASOME INHIBITION
CONCLUSION
CHAPTER 61:
Nasopharyngeal Cancer
DIAGNOSIS
MICROMETASTASIS AND RESIDUAL DISEASE
THERAPEUTIC APPROACHES
NEOADJUVANT CHEMOTHERAPY
CONCURRENT CHEMOTHERAPY
ADJUVANT CHEMOTHERAPY
NEOADJUVANT AND ADJUVANT CHEMOTHERAPY
CONCOMITANT AND ADJUVANT CHEMOTHERAPY
NEOADJUVANT AND CONCOMITANT CHEMOTHERAPY
MOLECULAR TARGETED THERAPY
RECOMMENDATIONS
RECURRENT NASOPHARYNGEAL CANCER
CONCLUSION
CHAPTER 62:
Anterior Skull Base Tumors
ANATOMY OF THE ANTERIOR CRANIAL FOSSA
LESIONS OF THE ANTERIOR CRANIAL FOSSA
Esthesioneuroblastoma
Clinical Features
Diagnosis
Treatment Options
Paranasal Sinus Cancer
Meningiomas
Clinical Features
Investigations
Melanoma
Chordoma
Sarcomas
Histiocytosis X
Sinonasal Lymphoma
Sinonasal Undifferentiated Carcinoma (SNUC)
SURGICAL TECHNIQUE
Supraorbital Keyhole Approach
Other Minimally Invasive Approaches
Glabellar Approach
Endoscopic Anterior Cranial Skull Base Resection
Complications of Surgical Procedures
Recurrent Tumors
CONCLUSION
CHAPTER 63:
Cancer of the Temporal Bone
HISTORICAL ASPECTS
INTRODUCTION
Incidence
Demographics
Etiology
Clinical Features
Patient Evaluation
Staging
Treatment
Formal Temporal Bone Resection
Management of the Neck
Reconstruction
Complications
Cranial Nerve Rehabilitation
Facial Nerve Injury
Speech and Swallowing Rehabilitation
Radiation
Controversies
Results
CONCLUSION
CHAPTER 64:
Cancer of the Paranasal Sinuses and Nasal Cavity
HISTORICAL BACKGROUND
Epidemiology
Presentation
ANATOMY (FIGS 64.7 TO 64.10)
Maxillary Sinus
Nasal Cavity (Figs 64.8 to 64.10)
THE UNCINATE PROCESS
Ethmoid Sinus
Sphenoid Sinus
Frontal Sinus and Recess
Pterygopalatine Fossa (PPF)
INFRATEMPORAL FOSSA (ITF)
Lymphatic Drainage
PATHOLOGY
Benign Lesions
Papillomas
Squamous Papilloma15
Inverted Papilloma18,19
Fungiform
Cylindric15
Osteomas
Fibrous Dysplasia
Neurogenic Tumors
Hemangioma
MALIGNANT LESIONS
Squamous Cell Carcinoma (SCC)
Adenocarcinoma
Sinonasal Undifferentiated Carcinoma (SNUC)
Adenoid Cystic Carcinoma
Mucoepidermoid Carcinoma
Hemangiopericytoma
Melanoma
Olfactory Neuroblastoma or Esthesioneuroblastoma
Osteogenic Sarcoma
Chondrosarcoma
Rhabdomyosarcoma
Lymphoma
Extramedullary Plasmacytoma
Teratomas and Related Neoplasms
Basal Cell Carcinoma
Metastatic Tumors
IMAGING
Magnetic Resonance Imaging (MRI)
STAGING
TNM Staging88
Maxillary Sinus—Primary Tumor (T)
Nasal Cavity and Ethmoid Sinus—Primary Tumor (T)
Regional Lymph Nodes (N)
Distant Metastasis (M)
Stage Groupings
TREATMENT METHODS FOR TUMORS OF NASAL CAVITY AND PARANASAL SINUSES
Surgery
Total Maxillectomy
Partial Maxillectomy
Infrastructure Maxillectomy
Medial Maxillectomy
Suprastructure Maxillectomy
Subtotal Maxillectomy
Radical Maxillectomy
Craniofacial Resection
Contraindications for Surgery
Nasal Cavity Tumors
Inverting Papilloma
Sinonasal Melanomas
Endoscopic Sinus Surgery
Diagnostic
Therapeutic
RADIOTHERAPY
CHEMOTHERAPY
Intra-arterial Chemotherapy
Recurrent Tumors
COMPLICATIONS AND REHABILITATION OF TUMORS OF NASAL CAVITY AND PARANASAL SINUSES
Complications
Bleeding
Mucositis
Xerostomia
Trismus
Visual Abnormalities
Epiphora or Lacrimal Outflow Deficiency
Swallowing Disturbances
Speech Disturbances
Cheek Retraction
Leak of CSF
Reconstruction
Rehabilitation
Preoperative Visit to Prosthodontist
Tips to Enhance the Proper Placement of Prosthesis
Obturators
Care of Obturator202
Follow-up
ACKNOWLEDGMENT
CHAPTER 65:
Oral Cavity Cancer
ANATOMY
ETIOLOGY
MOLECULAR AND GENETIC CHANGES
SQUAMOUS CELL CARCINOMA OF THE ORAL CAVITY
BIOLOGICAL MARKERS FOR SQUAMOUS CELL CARCINOMA OF THE ORAL CAVITY
PATHOLOGY
Premalignant Lesions and Conditions
Leukoplakia
Erythroplakia
Lichen Planus
Oral Submucosal Fibrosis
Squamous Cell Carcinoma
Nonepithelial Malignant Lesions
Salivary Gland Cancer
Kaposi Sarcoma
Lymphoma
Melanoma
NATURAL HISTORY
Primary
Regional Metastasis
Rate of Regional Metastasis
Patterns of Neck Metastasis
Distant Metastases
Second Primary
DIAGNOSIS
Clinical Evaluation
Investigations
Primary
Neck
Mandible
Distant Metastasis
Staging
Components of the TNM System
TREATMENT
Surgery
Ablative Surgery of the Primary
Management of the Neck
Clinically Positive Neck
Clinically Negative Neck
Management of Mandible
Bone Involvement
Marginal Mandibulectomy
Segmental Mandibulectomy
Reconstructive Surgery in Oral Cavity Cancer
Transoral Excision
Mandibulotomy or Mandibular Swing
Airway Handling
Radiotherapy
Single-Modality Radiotherapy
Adjuvant Radiotherapy
Reirradiation
Chemotherapy
Photodynamic Therapy
Rehabilitation
Eating, Swallowing and Speech
Dental Hygiene and Prosthetic Restoration
Treatment Complications
Management
Results and Outcome
Prognostic Factors in Oral Cavity Cancer
Local Control
Survival
Site-Specific Factors
Lip
Buccal Mucosa
Alveolar Ridge
Floor of Mouth
Tongue
Retromolar Trigone
Hard Palate
Quality of Life
Follow-up
CHAPTER 66:
Oropharyngeal Cancers
ETIOLOGIC FACTORS
SCREENING
Pathologic Diagnosis
CLINICAL PRESENTATION
DIAGNOSTIC STRATEGY
Imaging
Staging
Primary Tumor (T)
Regional Lymph Nodes (N)
Distant Metastasis (M)
AJCC Stage Groupings
PROGNOSIS
Treatment-related Prognostic Factors
Survival and Quality of Life
TREATMENT
General Strategy
Stage I–II
Stage III–IV
Stage III
Stage IV
Stage IVA
Stage IVB
Metastatic Disease
CHAPTER 67:
Thyroid Cancer
NEOPLASMS OF THE THYROID
Adenomas
Malignant Tumors
Etiology
Differentiated Thyroid Carcinoma
Pathology
Diagnosis
Prognostic Factors and Staging System
Management
Indications and Extent of Lymph Node Dissection
Treatment of Recurrent and Metastatic Disease
Thyroxine Suppression
Follow-up
Special Considerations in Thyroid Cancer
Medullary Thyroid Carcinoma
Pathology
Tumor Markers
Diagnosis
Treatment of MTC
Prophylactic thyroidectomy
Follow-up
Anaplastic Thyroid Cancer
Diagnosis
CHAPTER 68:
Tumors of the Parathyroid Gland
EPIDEMIOLOGY
PATHOGENESIS
CLINICAL PRESENTATION
EVALUATION
MANAGEMENT OF PARATHYROID ADENOMA
MANAGEMENT OF PARATHYROID CARCINOMA
CHAPTER 69:
Management of Salivary Gland Neoplasms
ETIOLOGY
EVALUATION
Clinical Presentation
Cytology
Imaging
Anatomical Subtypes
Histological Subtypes
Staging
TREATMENT
Parotid Tumors
Tumors of the Deep Lobe of the Parotid Gland
Excision of Accessory Parotid Tumor
Submandibular Gland Tumors
Sublingual Glands Tumors
Tumors of Minor Salivary Glands
COMPLICATIONS OF SURGERY
Facial Nerve
Hematoma
Frey's Syndrome
MANAGEMENT OF THE NECK
Primary Radiation Therapy
Adjuvant Treatment
External Beam Radiation Therapy
Neutron Beam Radiation Therapy
Chemotherapy
FOLLOW-UP
Surveillance
Outcomes
CHAPTER 70:
Management of Larynx and Hypopharynx Cancer
EPIDEMIOLOGY
Risk Factors
ANATOMY
Larynx
Hypopharynx
Routes of Spread10–13
Glottic Carcinomas
Supraglottic Carcinomas
Subglottic Carcinomas
Pyriform Sinus
Postcricoid Area
Posterior Pharyngeal Wall
CLINICAL ASPECTS
Presenting Symptoms
Larynx
Hypopharynx
Pretreatment Work-up
Clinical Examination
Laboratory Investigations
Radiological Investigations
Endoscopic Examination
Pathology
Staging
Primary tumor (T)
Larynx
Regional Lymph Nodes (N)
Distant Metastasis (M)
Stage Grouping
MANAGEMENT OF SCC OF LARYNX AND HYPOPHARYNX
SURGICAL OPTIONS
Larynx Cancer
Hypopharynx
RADIOTHERAPEUTIC OPTIONS
Definitive Irradiation
Larynx Cancer
Hypopharynx
Postoperative Irradiation
CHEMOTHERAPEUTIC OPTIONS
Protocols with Curative Intent
Larynx Preservation with Induction Chemotherapy
Larynx Preservation with Concurrent Chemoirradiation
New Approaches for Larynx Preservation
Protocols with Palliative Intent
GENERAL GUIDELINES FOR MANAGEMENT
SUMMARY
CHAPTER 71:
Open Partial Laryngeal Procedures
EVOLUTION OF LARYNGEAL PROCEDURES
ANATOMIC BASIS OF TUMOR PATTERN
EVALUATION
Clinical Evaluation
Imaging
PARTIAL LARYNGECTOMY FOR GLOTTIC CANCER
Laryngofissure and Cordectomy
Indications
Procedure
Postoperative Care
Complications
Outcome
Vertical Partial Laryngectomy
Indications
Procedure
Postoperative Care
Complications
Outcome
PARTIAL LARYNGECTOMY FOR SUPRAGLOTTIC CANCER
Supraglottic Laryngectomy
Contraindications
Procedure
Postoperative Care
Complications
Outcome
RADIATION MODALITY
Radiation Therapy Technique
T1N0 and T2N0 Glottic and Supraglottic Cancers
Advanced Stage Cancers
CHAPTER 72:
Partial Laryngectomy for Advanced Laryngeal and Oropharyngeal Tumors
SURGICAL PRINCIPLES OF LARYNGECTOMY
ANATOMY AND EMBRYOLOGY
Preoperative Evaluation
SUPRACRICOID PARTIAL LARYNGECTOMY WITH CRICOHYOIDOEPIGLOTTOPEXY–I
Indications
Oncologic Results
Surgical Technique
Exposure
Resection
Reconstruction
SUPRACRICOID PARTIAL LARYNGECTOMY WITH CRICOHYOIDOEPIGLOTTOPEXY–II
Indications
Oncologic Results
Surgical Technique
Exposure
Resection
Reconstruction
OUTCOME AND COMPLICATIONS FOR SCPL
Postoperative Care for SCPL
NEAR-TOTAL LARYNGECTOMY
MICROVASCULAR LARYNX RECONSTRUCTION
CHAPTER 73:
Neck Dissection
HISTORY
FASCIAL COMPARTMENTS OF THE NECK
Lymphatics of the Neck
Patterns of Lymph Node Metastases
DIAGNOSTIC EVALUATION
Clinical Examination
IMAGING
Fine Needle Aspiration
Staging
HISTOPATHOLOGY AND PROGNOSIS
Adverse Histological Features
Micrometastases
NECK DISSECTION TECHNIQUE
Radical Neck Dissection
Operative Steps
Modified Radical Neck Dissection
Operative Steps
Selective Neck Dissection
SND at Levels I, II, and III (Supraomohyoid)
SND Levels II, III, and IV (Anterolateral)
Extended Neck Dissection
Skin, Muscles, Nerves
Retropharyngeal Lymph Node (RPLN) Dissection
Paratracheal and Upper Mediastinal Lymph Node Dissection
Resection of the Carotid Artery
MANAGEMENT OF THE NECK
General Principles
The N+ Neck (Neck at N+ stage)
The N0 Neck (Neck at N0 stage)
ISSUES IN NECK DISSECTION
SND for the Clinically Positive Neck
Dissection of Level IIb
Superselective Neck Dissection
ADJUVANT THERAPY FOR NECK DISSECTION
Planned Neck Dissection
Sentinel Node Biopsy
COMPLICATIONS OF NECK DISSECTION
Shoulder Dysfunction
Infection
Air Leaks
Bleeding
Chylous Fistula
Facial and Cerebral Edema
Blindness
Apnea
Jugular Vein Thrombosis
Emergencies
Blow-out of Carotid Artery
Rupture of Jugular Vein
CHAPTER 74:
Skin Cancer
CLASSIFICATION OF SKIN CANCER
I. Nonmelanoma Skin Cancers (NMSC)
II. Cutaneous Malignant Melanoma (MM)
NONMELANOMA SKIN CANCERS (NMSC)
Basal Cell Carcinoma (BCC)
Epidemiology
Etiology
Behavior
Types of BCC
Squamous Cell Carcinoma (SCC)
Epidemiology
Etiology
Behavior
Merkel Cell Carcinoma (MCC)
Epidemiology
Behavior
Treatment
Cutaneous angiosarcoma
Epidemiology
Behavior
Treatment
Sebaceous Carcinoma
Epidemiology
Behavior
Treatment
Cutaneous Lymphoma (CTCL)
Epidemiology
Behavior
Treatment
Keratoacanthoma (KA)
Behavior
Treatment
Bowen's Disease
Epidemiology
Treatment
Actinic Keratosis
Epidemiology
Behavior
Treatment
CUTANEOUS MALIGNANT MELANOMA (MM)
Malignant Melanoma (MM)
Epidemiology
Etiology
Genetics
Clinical classification:
Investigation
Treatment
Treatment of Primary Lesion
Therapeutic Lymph Node Dissection
Elective Lymph Node Dissection
Sentinel Lymph Node (SLN) Biopsy
Radiation Therapy
Chemotherapy
Immunotherapy
Non-purified
Gene therapy
A note on Mucosal Melanoma
CHAPTER 75:
Tumors of the Cervical Trachea
EPIDEMIOLOGY
PRESENTATION
DIAGNOSTIC EVALUATION
HISTOLOGY
Treatment
Resectable Disease
Unresectable Disease
LONG-TERM RESULTS
CHAPTER 76:
Unknown Primary Tumor
CLASSIFICATION
CLINICAL EVALUATION
CLINICAL STAGING
PATHOLOGICAL ASSESSMENT OF THE NECK MASS
Fine Needle Aspiration (FNA)
Excisional Biopsy
Immunohistochemistry
Gene Expression Profiling
Radiologic Evaluation of Neck Mass
CT Scan
MRI
Positron Emission Tomography (PET) Scan
CT–PET
EXAMINATION UNDER ANESTHESIA
TREATMENT PROTOCOLS AND RESULTS OF THERAPY
SURGERY
RADIATION THERAPY ALONE
SURGERY AND RADIATION THERAPY
Chemotherapy
RARE CERVICAL METASTASES
Carcinoma Arising in a Branchial Cleft Cyst
METASTATIC MELANOMA
METASTATIC ADENOCARCINOMA
SUMMARY
CHAPTER 77:
Benign Aggressive Jaw Tumors
ODONTOGENIC TUMORS
Ameloblastoma
Histology
Pindborg's Tumor
Odontogenic Myxoma
Odontogenic Keratocyst
Gorlin-Goltz Syndrome
Juvenile Aggressive Ossifying Fibromas
Central Giant Cell Granulomas of the Jaws
Juvenile Aggressive Fibromatosis
CHAPTER 78:
Management of Parapharyngeal Tumors
ANATOMY
CLINICAL PRESENTATION
PREOPERATIVE EVALUATION
Imaging
Surgical Approaches
Tumors of the Prestyloid Parapharyngeal Space
Tumors of the Poststyloid Parapharyngeal Space
Indications for Surgery
Techniques
Carotid Body Tumor
Glomus Vagale Tumor
Neurogenic Tumor
Complications
Prestyloid Parapharyngeal Space
Poststyloid Parapharyngeal Space
CHAPTER 79:
Other Nonsquamous Tumors
ADENOID CYSTIC CARCINOMA
Histopathology
PERINEURAL SPREAD
LYMPHATIC SPREAD
DISTANT METASTASES
SURVIVAL
SURGICAL ANATOMY
Treatment Options
Surgery
Radiotherapy
LYMPHOMAS
Clinical Presentation
IMMUNOHISTOLOGIC CLASSIFICATION
Hodgkin's Lymphoma
Non-Hodgkin's Lymphoma
Histology
Immunochemistry
Clinical Diagnosis and Behavior
Etiology
Epidemiology
Diagnostic Evaluation
Treatment
MALIGNANT MUCOSAL MELANOMA
Incidence
Etiology and Pathogenesis
Staging
Treatment
Prognosis
Survival
SPECIFIC SITES IN THE HEAD AND NECK
Primary Melanoma of the Oral Cavity
Primary Sinonasal Melanoma
Histological Diagnosis
Staging
Differential Diagnosis
Primary Melanoma of the Parotid Gland
Primary Melanoma of the Lacrimal Sac
Primary Melanoma of the Larynx
Metastatic Melanoma to the Upper Respiratory Tract
SOFT TISSUE SARCOMAS
Classification
Etiology
Molecular Basis
Clinical Presentation
INVESTIGATIONS
Radiation-induced Sarcomas
Staging
Treatment
Radiation Therapy
Chemotherapy
Outcome and Prognostic Indicators
MALIGNANT FIBROUS HISTIOCYTOMA
RHABDOMYOSARCOMA
FIBROSARCOMA
DERMATOFIBROSARCOMA PROTUBERANS
LIPOSARCOMA
SYNOVIAL SARCOMA
ANGIOSARCOMA
EXTRASKELETAL MYXOID CHONDROSARCOMA
NEUROGENIC SARCOMA
TREATMENT OUTCOMES
CHAPTER 80:
HIV and Head and Neck Cancers
HIV DISEASE AND IMMUNE SUPPRESSION
Focus on the Indian Subcontinent
Cancers in HIV-infected Adults and Adolescents
Kaposi Sarcoma
Epidemiology
Pathology and Pathogenesis
Clinical Manifestations
Diagnosis
Staging
Therapy
Local Therapies
Systemic Therapies
Non-Hodgkin's Lymphoma
Epidemiology
Pathology and Pathogenesis
Clinical Manifestations
Diagnosis
Staging and Prognosis
Therapy
Squamous Cell Carcinoma
Epidemiology
Pathology and Pathogenesis
Diagnosis
Staging and Prognosis
Therapy
MEDICAL MANAGEMENT IN HEAD AND NECK CANCERS
CHAPTER 81:
Emergencies in Surgical Oncology
AIRWAY OBSTRUCTION
Etiology and Classification
History and Physical Examination
Management
HEMORRHAGE
Etiology and Risk Factors
Classification
Management
Complications and Prognosis
CHAPTER 82:
Margins in Head and Neck Cancers
SURGICAL MARGIN
POSITIVE MARGIN
Role of Frozen Sections
INCIDENCE OF POSITIVE OR INVOLVED MARGINS
Rates of Prevalence
Role of Tumor Size
Role of Tumor Site
PROGNOSIS OF MARGINS WITHOUT ADJUVANT TREATMENT
POSITIVE MARGINS IN INVASIVE TUMOR
Oral Cavity and Pharyngeal Cancer
Laryngeal Cancer
Bony Extension
Positive Margins in Close Margins and Dysplasia
PROGNOSIS OF POSITIVE MARGINS WITH ADJUVANT TREATMENT
Wait and Watch
Additional Surgery or Re-resection
Radiation or Chemoradiation
External Beam Radiation
Brachytherapy
Chemotherapy
MOLECULAR BIOLOGY OF SURGICAL MARGINS
OTHER MALIGNANCIES
Cutaneous Carcinomas
MALIGNANCIES OF THE SALIVARY GLANDS
ORAL AND MAXILLOFACIAL SARCOMAS
THE FRANKFURT METHOD
CHAPTER 83:
Salvage Surgery
PRINCIPLES OF SALVAGE SURGERY
DIAGNOSIS OF RESIDUAL OR RECURRENT CANCER
ORAL CAVITY AND OROPHARYNX
HYPOPHARYNX
LARYNX
NASOPHARYNX
NECK
COMPLICATIONS
Salvage Surgery for Distant Metastases
CHAPTER 84:
Data Collection and Audit
DATA COLLECTION
Patient Demographic and Registration Details
Risk Factors at First Diagnosis
History of Non-head and Neck Cancer
Referral Details
Tumor Event
Surgery and Postsurgery Pathology Details
Radiotherapy Details
Chemotherapy Details
Post-treatment Performance Status and Quality of Life
Current Status
COMORBIDITY
RADIOTHERAPY AND CHEMOTHERAPY
TUMOR MAPS AND PHOTOGRAPHIC DOCUMENTATION
CLINICAL AUDIT PROCESSES
SUMMARY
CHAPTER 85:
Outcome Assessment in Head and Neck Cancer
IMPORTANCE OF OUTCOME ASSESSMENT
TYPES OF OUTCOME ASSESSMENT
Survival
Determinate Survival
Actuarial Survival
Kaplan-Meier Survival
Median Survival
Overall Survival, Disease-specific Survival and Relapse-free Survival
Adjustment of Survival for Prognostic Factors
Morbidity
Comorbidity
Acute Toxicity
Late Toxicity
Patient-centerd and Patient-reported Outcomes
Performance Status
Health Status and Functional Status
Quality of Life
Utility
Satisfaction
Tumor Outcome
Local and Locoregional Control
Response Rate
Parameters in Medical Decision-making
SUMMARY
CHAPTER 86:
Quality of Life in Head and Neck Cancer
QUALITY OF LIFE — DEFINITION
HN-specific QOL Research
CURRENT STATUS OF QOL INVESTIGATION
Rationale for the Conference
CONCLUSIONS OF THE CONFERENCE
Standards for Measuring QOL
Commonly Used QOL Investigational Tools
Identification of High Quality Outcome Measures
Timing of Collection of QOL Data
Standards for Reporting QOL
Adherence to Scientific Study Design
Users’ Guide for Developing and Reporting QOL Data
OUTLOOK FOR QOL
Active Clinical Use of QOL Information
Potential Areas for QOL Research
QOL Instruments in Clinical Care
Analysis of Functional Outcomes
Assessment of ‘Transitional’ QO
Translation of QOL Instruments and International QOL Research
Stratification Variable in Multi-institutional Trials
Assessment of Long-term Outcomes
Chemotoxicity and Cognitive Impairment
Palliative Care
Cost–Utility Assessment
CHAPTER 87:
Molecular Markers in Head and Neck Cancers
SUMMARY
CHAPTER 88:
Laser in Head and Neck Cancer
CARBON DIOXIDE LASER
Nd:YAG Laser
Argon Laser
KTP-532 Laser
Diode Laser
EARLY LARYNGEAL CANCER
Clinical Classification
Progression of Laryngeal Cancer
Criteria for Endoscopic Treatment and Instrumentation
EARLY GLOTTIC CANCER
Diagnostic Work-up
Classification of Cordectomies
Excisional Biopsy Approach for Tis–T1a Lesions
Compartmental Approach for T1b–T2 Lesions
Oncologic Outcome
Vocal Outcome
Complications and Patient Counseling
EARLY SUPRAGLOTTIC CANCER
Diagnostic Work-up
Modulation of Endoscopic Resections
Oncologic Outcome
Functional Outcome
Complications
ORAL AND OROPHARYNGEAL CANCER
General Considerations
Progression of the Tumor
Pathways of Diffusion
Selection of Cases Suitable for Laser Excision
Operative Technique
Healing Process and Postoperative Care
Tracheal Tumors and Tumor-like Lesions
CHAPTER 89:
Lymphoscintigraphy and Sentinel Node Biopsy
HISTORY OF SENTINEL NODE BIOPSY
Cutaneous Malignant Melanoma
Mucosal Squamous Cell Carcinoma
Equipment
Procedure
Salient Points of the Technique
Skip Metastasis
Method of Localization
Intraoperative Technical Challenges
Pathologic Analysis of Specimens
Ultrastaging
Radioguided Thyroid Surgery
Radioguided Parathyroid Surgery
SUMMARY
CHAPTER 90:
Minimally Invasive Surgery in Otolaryngology: Endoscopic and Robotic
ADVANTAGES AND DISADVANTAGES
EQUIPMENT
INDICATIONS
TECHNIQUES FOR APPROACH
Anterior Skull Base
Infratemporal/Pterygopalatine FOSSA
Resection Extent
Adjuvant Therapy
OUTCOMES
Outlook for the Future
ACKNOWLEDGMENTS
CLASSIFICATION
Capabilities of Surgical Robotic Systems
ADVANTAGES AND DISADVANTAGES OF ROBOTIC SYSTEMS
Advantages
Disadvantages
SPECIFIC SURGICAL ROBOTIC SYSTEMS
SPECIFIC APPLICATIONS OF SURGICAL ROBOTICS
RHINOLOGY
OTOLOGY
Laryngology
Head and Neck Surgery
CONCLUSION
CHAPTER 91:
Management of the Carotid Artery in Advanced Head and Neck Cancer
EMERGENT MANAGEMENT OF CAROTID ARTERY INVOLVEMENT
ELECTIVE MANAGEMENT OF CAROTID ARTERY INVOLVEMENT
PREOPERATIVE EVALUATION
NONSURGICAL MANAGEMENT
SURGICAL MANAGEMENT
Surgical Procedure
Complications
SUMMARY
CHAPTER 92:
Reirradiation in Head and Neck Cancers
EPIDEMIOLOGY AND PATTERNS OF FAILURE
STAND-ALONE SURGERY OR CHEMOTHERAPY
FEASIBILITY OF REIRRADIATION
CONCOMITANT CHEMOTHERAPY AND REIRRADIATION
5FU, Hydroxyurea and Concomitant Radiation
NOVEL CHEMOTHERAPEUTIC REGIMENS
PROGNOSTIC FACTORS FOR REIRRADIATION
Debulking Surgery Prior to Reirradiation
Anatomic Site
Second Primary versus Recurrent Tumor
Time Interval Since Prior Irradiation
Evidence for a Dose-response Relationship
MULTIDISCIPLINARY APPROACH TO REIRRADIATION
SUMMARY
CHAPTER 93:
Management of Locally Advanced Inoperable Head and Neck Cancer
TREATMENT OPTIONS FOR LOCALLY ADVANCED HEAD AND NECK CANCER
Radical Surgery Followed by Adjuvant Therapy
General Considerations
Clinical Evaluation
Criteria of Operability
Adjuvant Therapy After Surgery
Combined Chemotherapy and Radiation
Conventional (Intravenous) Chemoradiation
Intra-arterial Chemoradiation (Radplat)
Adverse Effects of Chemoradiation
Outlook for the Future
CHAPTER 94:
Reconstruction after Resection of Head and Neck Cancers
CONCEPTS OF RECONSTRUCTION
Resection
Patient Factors
Defect Factors
Regional Perfusion
Donor Site Factors
Postoperative Care
Specific Flaps
Regional Flaps (Intact Pedicle: Muscle/ Musculocutaneous Flaps)
Distant Free Flaps (Microvascular Anastomosis)
Important Local (Advancement) Flaps
PECTORALIS MAJOR MUSCULOCUTANEOUS FLAP
Anatomy
Flap Design
Raising the Flap
Remember
Applications
Advantages
Disadvantages
BUCCINATOR MUSCULOMUCOSAL FLAP
Anatomy
Flap Design
Raising the Flap
Remember
Advantages
Disadvantages
Complications
Applications
PLATYSMA MUSCULOCUTANEOUS FLAP
Anatomy
Flap Design
Raising the Flap
Remember
Advantages
Disadvantages
Complications
Applications
PALATAL ISLAND FLAP
Raising the Flap
Remember
STERNO (CLEIDO) MASTOID FLAP
Anatomy
Flap Design
Raising the Flap
Remember
Advantages
Disadvantages
Applications
THE RADIAL FOREARM FREE FLAP
Anatomy
Flap Design
Raising the Flap
Remember
Advantages
Disadvantages
Applications
RECTUS ABDOMINIS FREE FLAP
Anatomy
Flap Design
Raising the Flap
Remember
Advantages
Disadvantages
Applications
FIBULA FREE FLAP
Anatomy
Flap Design
Raising the Flap
Remember
Setting the Graft
Advantages
Disadvantages
Applications
PHARYNGEAL ADVANCEMENT FLAPS
OTHER LOCAL FLAPS
POSTOPERATIVE CARE OF ALL FLAP RECONSTRUCTIONS
Flap Perfusion
Hematoma
Infection
SITE-SPECIFIC RECONSTRUCTION
Oral Cavity
Tongue
Floor of Mouth
Mandible
Larynx and Pharynx
Skin
Midface
CHAPTER 95:
Dysfunction in Swallowing
NORMAL PHYSIOLOGY OF SWALLOWING
SWALLOWING OUTCOMES ASSOCIATED WITH SURGERY
Oral Cavity
Pharyngeal and Laryngeal Tumors
SWALLOWING OUTCOMES AFTER NONSURGICAL, ORGAN-SPARING ALTERNATIVE TREATMENTS
METHODS OF ASSESSING SWALLOWING FUNCTION
Noninstrumental Assessments
Instrumental Assessments
CONCLUSION
CHAPTER 96:
Comprehensive Rehabilitation after Total Laryngectomy
CHALLENGES IN REHABILITATION AFTER TOTAL LARYNGECTOMY
POSTLARYNGECTOMY VOICE REHABILITATION
HISTORY OF PROSTHETIC VOICE REHABILITATION
Indwelling versus Nonindwelling Prostheses
Preoperative Counseling
Surgical Aspects
Sphincter Tonicity and Control of the PE Segment
Tracheostoma Construction
Secondary TEP
Adverse Events and Solutions
Device-related Indications for Replacement
Fistula-related Indications for Replacement
VOICE AND SPEECH THERAPY
Principles of Prosthetic Voice Acquisition
PULMONARY REHABILITATION
Heat and Moisture Exchangers (HMEs)
Treatment Aspects
Prevention Aspects
Compliance Aspects
OLFACTORY REHABILITATION
CONCLUSION
CHAPTER 97:
Pain and Palliative Care in Head and Neck Cancer
PAIN
Nociceptive
Neuropathic
Assessment of Pain and Other Symptoms
Guidelines for Treatment of Cancer Pain
Analysis of the WHO Ladder
Paracetamol—Acetaminophen
Selective COX 2 Enzyme Inhibitors
Low Potency Opioid Agonists
Codeine
Tramadol
Propoxyphene
Hydrocodone
High Potency Opioid Agonists
Morphine
Oxycodone
Hydromorphone
Meperidine
Fentanyl
Methadone
Dosing Methods of Opioids
Around the Clock Dosing (ATC)
Breakthrough Dosing (PRN or as Needed)
Patient-controlled Analgesia (PCA)
Side Effects of Opioids
Constipation
Nausea and Vomiting
Sedation
Cognitive Impairment
Respiratory Depression
Myoclonus
Urinary Retention
Analgesic Adjuvants
Nonpharmacologic Treatment
FATIGUE
Assessment of Fatigue
Management of Fatigue
DYSPNEA
Assessment of Dyspnea
Treatment of Dyspnea
Symptomatic Treatment
General Supportive Measures
DELIRIUM
Clinical Features
Assessment
Treatment of Delirium
DEPRESSION
Assessment of Depression
Treatment
CACHEXIA
Nonpharmacological Therapy
NUTRITION
Methods of Nutritional Supplementation
Functional Impairments
Tumor-related Impairments
Treatment-related Deformities and Symptoms
CONCLUSION
CHAPTER 98:
Nuclear Medicine in Head and Neck Oncology
BONE SCANNING
SALIVARY GLAND IMAGING
SENTINEL LYMPH NODE BIOPSY AND LYMPHOSCINTIGRAPHY
THYROID IMAGING
PARATHYROID IMAGING
FDG-PET
NUCLEAR CARDIOLOGY
CHAPTER 99:
Role of Dentistry
EARLY DETECTION AND PREVENTION
RISK FACTOR ASSESSMENT
Age
Past History of Premalignant/Malignant Lesions
Immunocompromised State
Tobacco Use
Alcohol Use
Poor Nutrition
Use of Other Orally Applied Carcinogens
PHYSICAL EXAMINATION
Extraoral Examination
Intraoral Examination
Lips
Labial Mucosae
Buccal Mucosae
Gingivae
Tongue
Floor of Mouth
Palate
Oropharynx
DIAGNOSTIC PROCEDURES
ORAL MANAGEMENT
Before the Treatment
Take the History
Perform an Examination
Counseling About Oral Complications of Cancer Treatment
Formulate Dental Treatment Plan
Extractions and Oral Surgery
Periodontal Therapy
Endodontic Therapy
Restorative Therapy
Prosthetic Therapy
Customizing a Preventive Plan
During Treatment
Maintain Oral Hygiene and Nutrition
Manage Mucositis
Intercept and Manage Infections
Managing Other Acute Complications
Trismus
Hemorrhage
Xerostomia
Other Dental Treatment
Following Treatment
Encourage and Reinforce Oral Hygiene and Nutrition
Diagnose and Manage Chronic Complications
Xerostomia
Radiation Caries
Osteoradionecrosis
Trismus
Dental Treatment and Rehabilitation to Optimize Masticatory Function
CHAPTER 100:
Role of Nutrition in Squamous Cell Carcinoma
OVERVIEW OF NUTRITIONAL FACTORS
MUTAGEN SENSITIVITY
Diet and Mutagen Sensitivity
TOBACCO AND NUTRITION
ALCOHOL AND NUTRITION
CHEMOPREVENTION AND NUTRITION
Selenium
Zinc
Phytochemicals in Cancer Prevention
Carotenoids and Retinoids
Lycopene
Soy
Vitamin E
Folic Acid
Green Tea
CANCER THERAPY AND NUTRIENTS
Radiation and Chemotherapy
Vitamin E
Zinc
Selenium
Gastrointestinal Toxicity
Nephrotoxicity
ANTITUMOR EFFECTS OF RADIATION/CHEMOTHERAPY
PREVENTION OF RADIATION AND CHEMOTHERAPY TOXICITY
CHAPTER 101:
Nursing Considerations in Surgery
IMPORTANCE OF NURSING IN CANCER
GLOBAL ISSUES IN HEAD AND NECK NURSING
PARAMETERS IN NURSING
Sociocultural Contexts for Care
Preoperative and Postoperative Care
Patient and Family Education
Airway Assessment and Management
Anxiety and Distress
Nutrition
Activity
Wound and Oral Care
Pain
DEVELOPMENT AND NEW ROLES FOR NURSING
Nurse Specialist Roles
Patient-held Diaries
Tobacco Cessation
Palliative Care
CHAPTER 102:
Anesthesia for Head and Neck Surgery
EQUIPMENT, SUPPORT SERVICES AND FACILITIES
PREOPERATIVE CONSIDERATIONS
Difficult Airway
Special Considerations in Intraoral Cancers
EFFECTS OF PRIOR THERAPY FOR CANCER
GENERAL PRINCIPLES OF ANESTHESIA FOR ORAL CANCERS
Induction of Anesthesia and Securing the Airway
Maintenance of Anesthesia
Intraoperative Problems
Postoperative Care
MICROVASCULAR RECONSTRUCTIVE SURGERY
Maintenance of Optimum Blood Flow
Prevent Vasoconstriction
Hypothermia
Brachytherapy
AIRWAY LESIONS
Obstructed Airway
Upper Airway Obstruction
SURGICAL ANESTHESIA PROCEDURES FOR LESIONS OF THE UPPER AIRWAY
IMMEDIATE POSTOPERATIVE COMPLICATIONS OF UPPER AIRWAY ENDOSCOPY
LASER RESECTIONS
LARYNGECTOMY
RIGID BRONCHOSCOPY
ROLE OF TRANSTRACHEAL JET VENTILATION
ANESTHESIA FOR MIDTRACHEAL OBSTRUCTION
MANAGEMENT OF TRACHEAL LESIONS
Preoperative Management
Intraoperative Management
CHAPTER 103:
Training of a Head and Neck Surgeon
HISTORY OF HEAD AND NECK SURGERY
Developments in Advanced Training Programs in the USA
Issues in the Training Programs in the USA
INTERNATIONAL SCENARIO IN TRAINING
OPTIMAL TRAINING PROGRAM
Current Dilemmas in Training
OUTLOOK FOR THE FUTURE
SECTION 4: LARYNGOLOGY
CHAPTER 104:
Congenital Anomalies of the Larynx and Trachea
RETROAGNATHIA AND GLOSSOPTOSIS
Airway Evaluation
Surgical Management
Postoperative Management
LARYNGOMALACIA
Airway Evaluation
Surgical Management
Postoperative Management
CONGENITAL GLOTTIC WEBS
Airway Evaluation
Surgical Management
Postoperative Management
CONGENITAL VOCAL FOLD PARALYSIS
Airway Management
Surgical Management
Postoperative Management
CONGENITAL SUBGLOTTIC STENOSIS
Airway Evaluation
Surgical Management
Postoperative Management
POSTERIOR LARYNGEAL CLEFTS
Airway Evaluation
Surgical Management
Postoperative Management
VASCULAR COMPRESSION
Airway Evaluation
Surgical Management
Postoperative Management
TRACHEOMALACIA
Airway Management
Surgical Management
Postoperative Management
COMPLETE TRACHEAL RINGS
Airway Management
Surgical Management
Postoperative Management
CHAPTER 105:
Head and Neck Imaging
CONGENITAL LESIONS OF THE HEAD AND NECK
Dermoid and Epidermoid Cysts
Encephaloceles
Dacryocystoceles
Craniofacial Syndromes
Apert's Syndrome
Crouzon's Syndrome
Treacher Collins' Syndrome (Mandibulofacial Dysostosis)
Branchial Arch Anomalies
First Branchial Arch Anomalies
Second Branchial Arch Anomalies
Third Branchial Arch Anomalies
Fourth Branchial Arch Anomalies
Parathyroid Anomalies
Thyroid Anomalies
Thyroglossal Duct Anomalies
External Auditory Canal Atresia and Hypoplasia
Large Endolymphatic Duct and Sac
Cochlear Anomalies
Vascular and Lymphatic Malformations
Cystic Hygroma
INFECTIONS
Otitis Media and Mastoiditis
Complications of Otitis Media and Mastoiditis
Sequelae of Chronic Otitis
Acute Petrositis
Cholesterol Granuloma
Malignant Otitis Externa
Labyrinthitis
Skull Base Inflammation
Danger Space of Neck
INFECTIONS OF THE PARAPHARYNGEAL SPACE (TABLE 105.1)
Masticator Space Infections
Ludwig's Angina
TRAUMA
Facial Fractures
Le Fort I
Le Fort II
Le Fort III
Lateral Midfacial Fractures
Trimalar Fractures
Temporal Bone Fractures
Ossicular Dislocation and Fracture
TUMORS
Epithelial Carcinomas of Larynx
Supraglottic Carcinoma
Glottic Carcinoma
Subglottic Carcinoma
Endolymphatic Sac Tumor
Acoustic Schwannoma
Labyrinthine Schwannoma
GLOMUS TUMORS OF JUGULAR FORAMEN
Chondrosarcoma of Skull Base
Chordoma
SOFT TISSUE TUMORS OF THE NECK
Lipomas and Liposarcomas
Hemangiomas
PAROTID GLAND TUMORS
Warthin's Tumor
Adenoid Cystic Carcinoma
Pleomorphic Adenoma
Muco-epidermoid Carcinoma
Buccal Carcinoma
BENIGN TUMORS OF THE LARYNX
BENIGN TUMORS OF EXTERNAL EAR
CHAPTER 106:
Deep Neck Space Infections
ANATOMY
CERVICAL FASCIA
Superficial Cervical Fascia
Deep Cervical Fascia
THE DEEP NECK SPACES (FIG. 106.1)
SPACES SPANNING THE ENTIRE NECK
The Superficial Space
The Retropharyngeal Space
The prevertebral space
The visceral vascular space
SUPRAHYOID SPACES
The Submandibular Space
The Parapharyngeal Space
The Parotid Space
The Peritonsillar Space
The Masticator Space
The Temporal Space
INFRAHYOID SPACE
The Anterior Visceral Space (Pretracheal Space)
DEEP NECK SPACE INFECTIONS
Causes and Presentations
Peritonsillar Abscess
Parapharyngeal Space Infections (Fig. 106.2)
Retropharyngeal Space Infections (Figs 106.3 and 106.4)
Prevertebral Space Infections
Danger Space Infections
Masticator Space Infections (Fig. 106.5)
Visceral Vascular Space (Carotid Space)
Pretracheal Space Infections (Fig. 106.6)
Parotid Space Infections
Temporal Space Infections
Microbiology
Evaluation and Management
History
Physical Examination
Signs
Investigations
Treatment
Indications for Surgical Intervention
Complications
CONCLUSION
CHAPTER 107:
Tonsils and Adenoids
ANATOMY
HISTOLOGY
PHYSIOLOGY
DISEASES OF THE ADENOIDS AND TONSILS
Adenotonsillar Hypertrophy
Management
Tonsillitis
Clinical Features
Differential Diagnosis
Complications
Medical Management
Malignancy
Surgery of the Adenoids and Tonsils
Contraindications
Technique
Consent and Complications
Tonsillectomy
Indications
Contraindications
Technique
Consent and Complications
Management of Postoperative Bleeding
CHAPTER 108:
Infections and Inflammatory Disorders of the Upper Respiratory Tract and Larynx
CONDITIONS REQUIRING HOSPITAL ADMISSION
Acute Sinusitis
ACUTE COMMUNITY-ACQUIRED SINUSITIS
Clinical Diagnosis
Investigations
Nonsurgical Treatment
Surgical Management
Persisting Sinusitis
Hospital-acquired Sinusitis
Fungal Sinusitis
ACUTE PHARYNGOTONSILLITIS
INFECTIOUS MONONUCLEOSIS
ACUTE EPIGLOTTITIS
ACUTE LARYNGITIS
LARYNGOTRACHEOBRONCHITIS (CROUP)
SPECIFIC INFLAMMATORY CONDITIONS OF THE LARYNX
INFECTIONS
Tuberculosis
Scleroma
Diphtheria
Syphilis
Leprosy (Hansen's Disease)
Actinomycosis
Nocardiosis
Mycosis of the Larynx
Histoplasmosis
Cryptococcosis
Candidiasis
Blastomycosis
Coccidioidomycosis
Paracoccidioidomycosis
Leishmaniasis
NONSPECIFIC INFLAMMATORY CONDITIONS
Wegener's Granulomatosis
Relapsing Polychondritis
Sarcoidosis
Amyloidosis
Angioedema
CONCLUSION
CHAPTER 109:
Voice Disorders
DEFINITION AND CLASSIFICATION
Diagnostic Evaluation
MANAGEMENT OF VOICE DISORDERS
Medical Management
Behavioral Management
Surgical Management
Quality of Life
Care of the Professional Voice
CHAPTER 110:
Vocal Cord Paralysis
ETIOLOGY
ETIOLOGY OF UNILATERAL VOCAL CORD PARALYSIS
Surgical Trauma (22–44%)
Nonsurgical Trauma (9–10%)
Neurological Causes (2–3%)
Malignancy (20–40%)17,19
Inflammatory and Infectious Causes (2–3%)
Idiopathic Causes (12–22%)19, 24
PATIENT EVALUATION AND ASSESSMENT
History
Physical Examination
Stroboscopic Evaluation
Investigations
Imaging
OBJECTIVE MEASURES OF VOICE
MANAGEMENT PRINCIPLES
Injection Medialization Techniques
Medialization Laryngoplasty
Medialization Technique (Thyroplasty Type I)
Implant Design
Implant Positioning
Arytenoid Adduction
Adduction Arytenopexy
Cricothyroid Subluxation
Reinnervation Techniques
SPEECH AND LANGUAGE THERAPY
BILATERAL VOCAL CORD PARALYSIS
Etiology
Symptomatology
Management
SUPERIOR LARYNGEAL NERVE PARALYSIS
PEDIATRIC VOCAL CORD PARALYSIS
Etiology
Presentation
Examination
MANAGEMENT
CONCLUSION
ACKNOWLEDGMENTS
CHAPTER 111:
Obstructive Sleep Apnea: Diagnosis, Evaluation and Management
EPIDEMIOLOGY
NORMAL SLEEP AND COMMON DEFINITIONS IN OSA
Pathophysiology of OSA
Clinical Features of OSA
Consequences of OSA
Cardiovascular Disorders
Cerebrovascular Disease
Pulmonary Disorders
Pulmonary Hypertension
Chronic Obstructive Pulmonary Disease (COPD)
Neuropsychological Effects
Motor Vehicle and Work-related Accidents
Diagnosis of OSA
Management of OSA
General Measures
Positive Airway Pressure Therapy
Oral Appliances
Surgical Treatment
Newer Techniques
Future Prospects
SUMMARY
ACKNOWLEDGMENT
CHAPTER 112:
Tracheostomy
INDICATIONS FOR TRACHEOSTOMY
Physiological Changes Caused by a Tracheostomy
Timing and Patient Selection for a Tracheostomy
OPERATIONS
Surgical Techniques
General Anesthesia
Positioning and Draping
Tracheostomy in Adults
Tracheostomy Under Local Anesthesia
Tracheostomy in Infants and Young Children
Percutaneous Dilatational Tracheostomy2–4
Advantages and Disadvantages of Percutaneous Tracheostomy
CRICOTHYROIDOTOMY
TRACHEOSTOMY TUBES
Cuffed Tracheostomy Tubes
Uncuffed Tracheostomy Tubes
Fenestrated Tracheostomy Tubes
Adjustable Flange Tracheostomy Tubes
POSTOPERATIVE TRACHEOSTOMY CARE
Immediately After Insertion
Humidification
Suction
Tube Care
General Care and Patient Education
Tube Change
COMPLICATIONS OF TRACHEOSTOMY
Immediate Complications
Early Complications
Late Complications
DECANNULATION
In Adults
In Infants and Young Children
RESUSCITATION OF A PATIENT WITH A TRACHEOSTOMY
CHAPTER 113:
Diseases of the Salivary Glands: Diagnosis, Evaluation and Management
ANATOMY
Embryology and Development
Gross Anatomy
MICROANATOMY/HISTOPATHOLOGY
PHYSIOLOGY OF SALIVARY SECRETIONS
AUTONOMIC CONTROL
COMPOSITION OF SALIVA
Factors Controlling the Production of Saliva
Methods of Collection of Saliva
DIAGNOSTIC EVALUATION IN SALIVARY GLAND DISEASES
Sialography
Radiosialography
Fine-needle Aspiration Cytology (FNAC)
Ultrasonography (USG)
Computed Tomography (CT)
Magnetic Resonance Imaging (MRI)
Biopsy
Sialendoscopy
NONNEOPLASTIC INFLAMMATORY DISEASES
Acute Inflammatory Disorders
Chronic Inflammatory Disorders
ACUTE INFLAMMATORY DISORDERS
Chronic Obstructive Inflammatory Disorders
Kussmaul's Disease
Sialolithiasis
Stricture of the Salivary Ducts
Sialectasis
Secondary Inflammatory Diseases of the Salivary Gland
Specific Sialadenitis
Benign Lymphoepithelial Disease (Sialectasia)
TRAUMATIC LESIONS OF SALIVARY GLANDS
SYSTEMIC DISEASES
Metabolic and Endocrine Disorders
IMMUNOLOGIC DISEASES
BENIGN SALIVARY GLAND TUMORS (TABLE 113.3)
Pleomorphic Adenoma
Warthin's Tumor
Myoepithelioma
Oncocytoma
Cystadenoma
Basal Cell Adenoma
ACKNOWLEDGMENT
CHAPTER 114:
Benign Disorders of the Thyroid and Parathyroid Glands
DISORDERS OF THE THYROID GLAND
Congenital Thyroid Lesions
CLASSIFICATION OF BENIGN THYROID TUMORS
Iodine Deficiency Goiters (Endemic Goiter)
Diffuse Colloid Goiter
Nodular Goiter
Dyshormonogenesis
CLINICAL PRESENTATION OF THYROID DISEASE
Solitary Thyroid Nodule
Multinodular Non-toxic Goiter
Diffuse Toxic Goiter/Graves’ Disease
Toxic Multinodular Goiter/Plummer's Disease
Toxic Solitary Nodular Goiter/Toxic Adenoma
Special Goiters
Hashimoto's Disease/Lymphadenoid Goiter
De Quervain's Thyroiditis
Reidel's Thyroiditis
DISORDERS OF THE PARATHYROID GLANDS
Benign Disorders
Primary Hyperparathyroidism
Parathyroid Adenoma
Parathyroid Hyperplasia
Chief Cell Hyperplasia
Clear Cell Hyperplasia
Carcinoma
MULTIPLE ENDOCRINE NEOPLASIA (MULTIPLE ENDOCRINE ADENOMATOSIS)
MEN I (Wermer's Syndrome)
MEN II (Sipple's Syndrome)
SECONDARY HYPERPARATHYROIDISM
TERTIARY HYPERPARATHYROIDISM
HYPOPARATHYROIDISM
PSEUDOHYPOPARATHYROIDISM
PARATHYROID CYSTS
CHAPTER 115:
Diseases of the Esophagus
ANATOMY
Nerve Supply
SYMPTOMS
Dysphagia
Oropharyngeal Dysphagia
Esophageal Dysphagia
Odynophagia
Heartburn
Globus Sensation1,2
Chest Pain
Extraesophageal Symptoms
CONGENITAL ANOMALIES
GASTROESOPHAGEAL REFLUX DISEASE
Etiopathogenesis
Symptoms
Atypical Symptoms
Special Conditions
Diagnosis
pH Studies
Treatment
Nonprescription Therapy
Acid Suppression
MOTOR DISORDERS
Achalasia Cardia22
Etiopathogenesis
Symptoms
Diagnosis
Esophageal Manometry
Treatment
Pharmacotherapy
Pneumatic Dilatation
Surgery
CAUSTIC INJURY
Etiopathogenesis
Acid-related Injuries
Alkali-related Injuries
Degree of Damage (Burns)
Clinical Manifestations
Early Symptoms
Late Symptoms
Prognostic Factors
Diagnosis
Upper Gastrointestinal Endoscopy
Treatment
Initial Management
Surgery
Delayed Complications
APPROACH TO A PATIENT WITH CAUSTIC INGESTION
TRAUMA
Diagnosis
Radiology
Endoscopy
Management
Upper Esophageal Perforation
Thoracic Esophageal Perforation
Perforations in Patients with Esophageal Cancer
Other Injuries
FOREIGN BODIES
History and Examination
Diagnosis
Management
Indications for Urgent Intervention
FOOD BOLUS IMPACTION
BLUNT OBJECTS
SHARP OBJECTS
DISK BATTERIES
NARCOTIC PACKAGES
ESOPHAGEAL TUMORS
Genetic Background
Clinical Features
Diagnosis
Endoscopy
Imaging Studies
Staging
Screening
Treatment
CHAPTER 116:
Foreign Bodies in the Aerodigestive Tract
TYPES OF FOREIGN BODIES
ETIOLOGY
PATHOGENESIS
CLINICAL PHASES
DIAGNOSIS
CLINICAL FEATURES
Oropharyngeal Foreign Bodies
Esophageal Foreign Bodies
Nasal Foreign Bodies
Laryngotracheal Foreign Bodies
Bronchial Foreign Bodies
COMPLICATIONS
MANAGEMENT OF AERODIGESTIVE TRACT FOREIGN BODIES
Investigations
Retrieval Planning and Timing
Retrieval Techniques
Bronchoscopy
Esophagoscopy
Complications of Retrieval
In the Airway
In the Esophagus
Prevention
CONCLUSION
CHAPTER 117:
Acquired Immunodeficiency Syndrome in Otolaryngology
THE AIDS VIRUS (HIV)
History
Epidemiology
HIV TESTING AND MONITORING
STAGING AND CLASSIFICATION OF HIV DISEASE
GENERAL MANAGEMENT ISSUES
OCCUPATIONAL EXPOSURE AND TREATMENT
Postexposure Prophylaxis
Prophylaxis for Maternal Transmission of HIV
GENERAL MANIFESTATIONS
Persistent Generalized Lymphadenopathy (PGL)
Pneumocystis Pneumonia (PCP)
Mycobacterial Infection
Candidiasis
Kaposi's Sarcoma
Lymphoma
Skin Lesions
Skin Carcinomas
OTOLARYNGOLOGICAL MANIFESTATIONS
External Ear Canal
Middle Ear
Inner Ear
Nose and Sinuses
Nasopharynx
Oral Cavity
Pharynx
Larynx
Esophagus
HEAD AND NECK MANIFESTATIONS
Parotidomegaly and Benign Parotid Cysts
Bacillary Angiomatosis
Rosai-Dorfman's Syndrome
PEDIATRIC HIV
CONCLUSION
INDEX
TOC
Index
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