Basic Concepts in HEAD AND NECK SURGERY AND ONCOLOGY
Basic Concepts in HEAD AND NECK SURGERY AND ONCOLOGY
SECOND EDITION
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Basic Concepts in Head and Neck Surgery and Oncology
First Edition: 2015
Second Edition: 2019
9789352708963
Printed at
Krishnakumar Thankappan, Subramania Iyer
- Abhijeet N Wakure DNB
- Consultant
- Department of Plastic Surgery
- Lakeshore Hospital and Research Center
- Kochi, Kerala, India
- Adharsh Anand MS MCh
- Assistant Professor
- Department of Surgical Oncology
- Malabar Cancer Center
- Kannur, Kerala, India
- Akshay Kudpaje MS MCh
- Consultant Head and Neck Surgeon
- Department of Surgical Oncology
- MVR Cancer Center
- Kozhikode, Kerala, India
- Anoop R MD
- Assistant Professor
- Department of Radiation Oncology
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- Chaya Prasad MD
- Assistant Professor
- Department of Pathology
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- Chinmay Kulkarni DNB
- Associate Professor
- Department of Radiodiagnosis
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- Deepak Balasubramanian MS DNB MCh
- Associate Professor
- Department of Head and Neck Surgery and Oncology
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- Divya GM DLO DNB
- Assistant Professor
- Department of ENT
- Government Medical College
- Kozhikode, Kerala, India
- K Pavithran MD DM
- Professor
- Department of Medical Oncology/Hematology
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- Krishnakumar Thankappan MS DNB MCh
- Professor
- Department of Head and Neck Surgery and Oncology
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- Mahamaya Prasad Singh MS MCh
- Consultant Head and Neck Surgeon
- North East Cancer Hospital and Research Institute
- Guwahati, Assam, India
- Mayuri Mohan Rajapurkar MS MCh
- Consultant Head and Neck Oncologic and Reconstructive Surgeon
- Aster Medcity Hospital
- Kochi, Kerala, India
- Mohit Sharma MS MCh
- Professor
- Department of Plastic Surgery
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- Prameela CG MD
- Associate Professor
- Department of Radiation Oncology
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- P Shanmuga Sundaram DRM DNB MNAMS
- Head and Clinical Professor
- Department of Nuclear Medicine and PET-CT
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- Pushpaja KU DMRT DNB
- Assistant Professor
- Department of Radiation Oncology
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- Rajsekar CS DNB MNAMS
- Assistant Professor
- Department of Radiodiagnosis
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- Salima Rema Windsor MS DLO DNB
- Assistant Professor
- Department of ENT
- Government Medical College
- Kollam, Kerala, India
- Sandya CJ MD
- Associate Professor
- Department of Radiodiagnosis
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- Shashikant Vishnubhai Limbachiya MS MCh
- Consultant Head and Neck Surgical Oncologist
- Narayana Health
- Ahmedabad, Gujarat, India
- Shibu George MS DNB
- Professor and Head
- Department of ENT
- Government Medical College
- Kottayam, Kerala, India
- Shreya Bhattacharya MS MCh
- Fellow-Head and Neck
- Department of ENT
- Sir Charles Gairdner Hospital
- Nedlands, Western Australia
- Sivakumar Vidhyadharan MS DNB
- Assistant Professor
- Department of Head and Neck Surgery and Oncology
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- Smitha NV DCP DNB
- Associate Professor
- Department of Pathology
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- Subramania Iyer MS MCh FRCS
- Professor and Head
- Division of Reconstructive Surgery
- Department of Head and Neck Surgery and Oncology
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- Vasantha Nair MD
- Professor
- Department of Endocrinology
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
It has been only a few years since the first edition of Basic Concepts in Head and Neck Surgery and Oncology by Thankappan and Iyer was first brought out in 2015. The book has had significant success, and in keeping with the expectations of its readers, the authors’ have now brought out a second edition, which incorporates the recent developments in the subject
The second edition retains the strengths and the style of the first edition. It is simply written, comprehensive, and yet concise in its inclusion of the must-know and essential facts in the subject. Basic and fundamental concepts in the subject are very well covered, and the principles of evaluation and management well elucidated. The book is essentially a compilation of the current state of knowledge in the subject, which is distilled with the very considerable experience of the Head-Neck Team at the Amrita Institute of Medical Sciences at Kochi.
Specific inclusions and updates in the current edition include the current AJCC 8th Edition staging system, new chapters on parathyroid tumors, temporal bone tumors, and cutaneous cancers, and the current hot topics in the subject including Robotic surgery, and the promise of monoclonal antibodies and Immunotherapy. The reader shall find the book to be a sufficient resource to the fundamental knowledge necessary to practice evidenced based management of head and neck cancers.
My congratulations to the authors for their enthusiasm and commitment in bringing out this excellent textbook, which will certainly prove very useful and educative for all aspiring students in the subject.
Alok Thakar MS FRCSEd
Professor
Department of Otolaryngology
All India Institute of Medical Sciences
New Delhi, India
FOREWORD TO THE FIRST EDITION
It is indeed a great honor for me to write the foreword for the textbook Basic Concepts in Head and Neck Surgery and Oncology, edited by Dr Krishnakumar Thankappan and Professor Subramania Iyer. This book has its origin as a manual for the ever-popular Annual Head and Neck Oncology Education Program of Amrita Institute of Medical Science (AHEAD). This was started over 10 years ago primarily meant for trainees and junior faculty. The increasing number of delegates attending the program every year attests the popularity and need for such an educational event. The manual of this program is meant as a companion to this educational program. It is now expanded and made into an independent textbook. The contents and primary focus of the book are to simplify the concepts into day-to-day clinically applicable information. In this way, this book is quite distinct from all the other currently available textbooks in head and neck surgery and oncology. It is not meant as detailed textbook. In this book, the information is distilled into what is essential to practice the art and science of head and neck oncology. Another unique feature of this book is that each chapter is written by a leading expert in the field along with a trainee. Thereby, at every level from choosing the topics, to contents of these chapters, the end-users point-of-view is kept in mind. The book is divided into seven sections; thyroid, salivary gland, parapharyngeal space, neck, paranasal sinuses, oral cavity, oropharynx, larynx, hypopharynx, nasopharynx, and general topics. Each section is divided into pathology, imaging and practical management guidelines. The 34 concise chapters of this book provide fundamental knowledge necessary to practice evidence-based management of head and neck cancer. Both the editors of this book, Dr Krishnakumar Thankappan and Professor Subramania Iyer, have proven track record of establishing one of the finest head and neck training programs of the country. This book not only attests their experience but also exemplifies their commitment in excelling in head and neck oncology training. I am confident that many trainees and junior faculties in the head and neck surgery, surgical oncology, otolaryngology and maxillofacial surgery will find this manual very useful.
Moni Abraham Kuriakose MD FRCS
Professor and Director
Department of Surgical Oncology
Mazumdar-Shaw Cancer Center
Narayana Health City
Bengaluru, Karnataka, India
PREFACE TO THE SECOND EDITION
Management of head and neck cancer has changed over the last few decades. This change has occurred due to the better understanding of the pathology and better delineation of the tumor by advances in imaging and diagnostic techniques. The management of these cancers has improved greatly with increased knowledge on the tumor behavior and its response to the therapeutic regimens. This is a result of the integration of the three modalities namely surgery, radiation and chemotherapy as applied to the management of these cancers. Function and organ preservation by surgery or chemoradiation and better rehabilitation by appropriate reconstructive surgery have made the quality of the treatment acceptable. The factor that has brought in the difference is the emergence of multidisciplinary approach in the research, diagnosis and management of these cancers. This short book is aimed at giving the reader an overview of the subject to reflect all these changes based on the contemporary knowledge in various subspecialties involved in the management of these cancers. The book does not claim to be an exhaustive reference book but as an easy revision manual for the practicing physicians and the trainees. Each of the subsites has been dealt with separately emphasizing on the diagnosis and management. Separate chapters have been added to discuss areas like radiation, chemotherapy, reconstruction and molecular biology. The contents of this book have been, in a much smaller way given as handout to the annual instructional course in head and neck surgery conducted by the Amrita Institute of Medical Sciences, Kochi, Kerala, India for the past several years.
The second edition reflects the advances that have occurred in the recent past, especially the changes in the staging system as reflected in the American Joint Cancer Committee (AJCC) 8th edition. The impact on the management of oral cavity, thyroid and occult primary cancers, due to these changes, has been highlighted. Newer modalities of treatment like robotic surgery and immunotherapy, which have taken their place in the treatment armamentarium, are also updated. Other additions in this edition include management of Human Papillomavirus (HPV) positive tumors, facial nerve issues, melanoma and skin cancers, tumors of infratemporal fossa and practical issues related to tracheostomy. The book still maintains its simplicity in dealing the subject, but at the same time, tries to reflect the contemporary knowledge.
Krishnakumar Thankappan
Subramania Iyer
PREFACE TO THE FIRST EDITION
Management of head and neck cancer has changed over the last few decades. This change has occurred due to the better understanding of the pathology and better delineation of the tumor by advances in imaging and diagnostic techniques. The management of these cancers has improved greatly with increased knowledge on the tumor behavior and its response to the therapeutic regimens. This is a result of the integration of the three modalities namely surgery, radiation and chemotherapy as applied to the management of these cancers. Function and organ preservation by surgery or chemoradiation and better rehabilitation by appropriate reconstructive surgery have made the quality of the treatment acceptable. The factor that has brought in the difference is the emergence of multidisciplinary approach in the research, diagnosis and management of these cancers.
This short book is aimed at giving the reader an overview of the subject to reflect all these changes based on the contemporary knowledge in various subspecialties involved in the management of these cancers. The book does not claim to be an exhaustive reference book but as an easy revision manual for the practicing physicians and the trainees. Each of the subsites has been dealt with separately emphasizing on the diagnosis and management. Separate chapters have been added to discuss areas like radiation, chemotherapy, reconstruction and molecular biology. The contents of this book has been, in a much smaller way given as handout to the annual instructional course in head and neck surgery conducted by the Amrita Institute of Medical Sciences, Kochi, Kerala, India for the past several years. The book still maintains its simplicity in dealing the subject, but at the same time, tries to reflect the contemporary knowledge.
Krishnakumar Thankappan
Subramania Iyer
ACKNOWLEDGMENTS
We would like to express our sincere gratitude to the Medical Director, Principal and the management of Amrita Institute of Medical Sciences, Kochi, Kerala, India, for their immense support to make this book a reality. The fellows, trainees and staff of the Department of Head and Neck Surgery and Plastic Surgery have also helped immensely. Special word of appreciation also goes to Bri Abhirami, Mr Dinesh and other staff, Department of Graphics of the Institute, for their help in the preparation of illustrations.
We are thankful to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Ms Chetna Malhotra Vohra (Associate Director—Content Strategy), and Ms Nikita Chauhan (Senior Development Editor) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for giving a go-ahead at the very beginning and helping us in every way possible to bring out this book.