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Head & Neck Surgery
David Goldenberg
SECTION 1: SINONASAL CANCER
CHAPTER 1:
Medial Maxillectomy
OVERVIEW
INDICATIONS
SURGICAL TECHNIQUES
Lateral Rhinotomy
Midfacial Degloving
POSTOPERATIVE CARE
COMPLICATIONS
CHAPTER 2:
Endoscopic Medial Maxillectomy
EVOLUTION
INDICATIONS
IMAGING
CONTRAINDICATIONS
EQUIPMENT AND SETUP
OPERATIVE STEPS
MAXILLARY ANTROSTOMY
ENDOSCOPIC MEDIAL MAXILLECTOMY
MODIFIED EMM
PRESERVATION OF THE INFERIOR TURBINATE
PRESERVATION OF THE NASOLACRIMAL DUCT
PTERYGOPALATINE AND INFRATEMPORAL FOSSA
POSTOPERATIVE CARE
SUMMARY
CHAPTER 3:
Maxillectomy
INTRODUCTION
ANATOMY
VASCULATURE
NERVES
ORBITAL DETAIL
SURGICAL PROCEDURES
Indications/Contraindications
TOTAL MAXILLECTOMY
Radiological Evaluation
SURGICAL STEPS
Approaches
Procedures
Soft Tissue Resection
Bony Resection
ORBIT
CLOSURE AND RECONSTRUCTION
POSTOPERATIVE CARE
COMPLICATIONS
Early Complications
Late Complications
CHAPTER 4:
Anterior Craniofacial Resection
INTRODUCTION
PRESENTATION AND INVESTIGATION
PATIENT SELECTION
PLANNING FOR SURGERY
Preparation for Surgery
The Operation
The Incisions and Approach Work
Tumor Resection
Reconstruction and Closure
POSTOPERATIVE CARE
COMPLICATIONS
Cerebrospinal Fluid Leak
Tension Pneumocephalus
Bleeding
Meningitis
Brain Abscess
Diplopia
Wound Infection
Seroma
Wound Healing Problems
RESULTS
KEY POINTS
CHAPTER 5:
Endoscopic Anterior Skull Base Resection and Endoscopic Repair of Skull Base Defects
ENDOSCOPIC ANTERIOR SKULL BASE RESECTION
Evolution
Indications
Open versus Endoscopic Approach
Imaging
Equipment and Setup
Operative Steps
ENDOSCOPIC REPAIR OF SKULL BASE DEFECTS
SUMMARY
SECTION 2: ORAL CAVITY AND OROPHARYNX
CHAPTER 6:
Surgical Management of Lip Cancer
BACKGROUND
ANATOMY
TREATMENT
Surgical Resection
Primary Closure
Local Advancement
Lesions One-Half to Two-Thirds of the Lip: Abbe and Estlander Flaps
POSTOPERATIVE CARE
CHAPTER 7:
Floor of Mouth Resection
RELEVANT ANATOMY
SURGICAL CONSIDERATIONS
SURGICAL TECHNIQUE
Transoral Excision and Split Thickness Skin Graft
Transoral Excision with Marginal Mandibulectomy
Composite Resection with or without Segmental Mandibulectomy
Lymphatic Spread and Neck Dissection
CHAPTER 8:
Surgical Management of Oral Tongue Cancer
INTRODUCTION
RELEVANT ANATOMY
EVALUATION OF THE PATIENT/INDICATIONS FOR THE PROCEDURE
SURGICAL TECHNIQUE
SURGICAL MANAGEMENT OF THE NECK
COMPLICATIONS, FUNCTIONAL CONSEQUENCES, AND POSTOPERATIVE CONSIDERATIONS
CHAPTER 9:
Composite Resection
BACKGROUND AND HISTORY
INDICATIONS
PHYSICAL EXAMINATION
IMAGING
SURGICAL PROCEDURE
Marginal Mandibulectomy
Segmental Mandibulectomy
RECONSTRUCTION OF THE DEFECT
Primary Closure
Split Thickness Skin Graft
Local Flaps
Regional Myocutaneous or Myofascial Flaps
Microvascular Free Flap Reconstruction
Postoperative Management
COMPLICATIONS
Marginal Mandibulectomy
Segmental Mandibulectomy
CHAPTER 10:
Mandibulotomy
INTRODUCTION
INDICATIONS AND PATIENT SELECTION
Relevant Anatomy
Patient Evaluation
MANDIBULOTOMY SURGICAL TECHNIQUE
RECONSTRUCTION
POSTOPERATIVE CARE AND COMPLICATIONS
CHAPTER 11:
Segmental and Marginal Mandibulectomy
INTRODUCTION
SEGMENTAL VERSUS MARGINAL MANDIBULECTOMY
INDICATIONS AND PATIENT SELECTION
Relevant Anatomy
Patient Evaluation
Imaging
SURGICAL TECHNIQUE
Segmental Mandibulectomy
Marginal Mandibulectomy
RECONSTRUCTION
POSTOPERATIVE CARE
SECTION 3: SURGERY OF THE LARYNX AND HYPOPHARYNX
CHAPTER 12:
Surgery for Larynx Cancer
INTRODUCTION
ANATOMY
FUNCTION
OPEN PARTIAL LARYNGECTOMY
Vertical Partial Laryngectomy
Laryngofissure with Cordectomy
Vertical Hemilaryngectomy with Imbrication Laryngoplasty
Frontolateral and Extended Approaches
Open Supraglottic Partial Laryngectomy
Supracricoid Partial Laryngectomy with Cricohyoidoepiglottopexy or Cricohyoidopexy (SCPL with CHEP or CHP)
Indications and Patient Selection
Special Considerations
Contraindications
Operative Technique
Operative Considerations
Postoperative Management
Complications
TOTAL LARYNGECTOMY
Indications and Patient Selection
Operative Technique
Operative Considerations
Postoperative Management
Complications
CHAPTER 13:
Surgery for Hypopharyngeal Cancer
ANATOMY
PATHOLOGY
BEHAVIOR OF HYPOPHARYNGEAL CANCER
Pyriform Sinus
Posterior Hypopharyngeal Wall
Postcricoid Carcinoma
TREATMENT OF HYPOPHARYNGEAL CANCERS
Transhyoid Pharyngectomy
Lateral Pharyngotomy
Lateral Transthyroid Pharyngotomy
Median Labiomandibular Glossotomy
Partial Laryngopharyngectomy
TRANSORAL APPROACH TO THE HYPOPHARYNX
Tumors of the Posterior Pharyngeal Wall
Lateral Wall of Pyriform Sinus
Medial Wall of Pyriform Sinus
Apex of the Pyriform Sinus
TOTAL LARYNGECTOMY WITH PARTIAL PHARYNGECTOMY
TREATMENT OF THE NECK
Selective Neck Dissection
CHAPTER 14:
Microlaryngoscopic Laser Excision of Glottic Malignancies
INTRODUCTION
INDICATIONS
SURGICAL TECHNIQUE
Preoperative Considerations
Positioning
Operative Steps
Postoperative Considerations
CHAPTER 15:
Transoral Robotic Surgery of the Larynx
INTRODUCTION
LIMITATIONS
PREOPERATIVE PLANNING
CONTRAINDICATIONS
TORS SUPRAGLOTTIC LARYNGECTOMY: SURGICAL PROCEDURE
SECTION 4: NECK DISSECTIONS
CHAPTER 16:
Radical Neck Dissection
INTRODUCTION
CLASSIFICATION, PERTINENT ANATOMY, AND SURGICAL LANDMARKS BY LEVEL
Level I(A/B)
Level II(A/B)
Level III
Level IV
Level V(A/B)
Level VI
Posterior Neck
INDICATIONS
CONTRAINDICATIONS
TREATMENT
Preoperative Evaluation
Antibiotics
Anesthesia and Positioning
Surgical Technique
RISK FACTORS AND COMPLICATIONS
Early Postoperative Complications
Neurologic Injuries
Vascular Injury
POSTOPERATIVE CARE
CONCLUSION
CHAPTER 17:
Modified Radical Neck Dissection
INTRODUCTION
ANATOMY
INDICATIONS
SURGICAL TECHNIQUE
Positioning, Incision Planning, and Flap Development
Submandibular Fossa
Dissection of the Sternocleidomastoid Muscle
Dissection of the Spinal Accessory Nerve
Dissection of the Carotid Sheath
Posterior Triangle
Wound Closure
POSTOPERATIVE CARE
COMPLICATIONS
Neurologic Complications
Thoracic Duct Injury
Vascular Complications
Surgical Site Infections
CHAPTER 18:
Selective Neck Dissection
INTRODUCTION
CLASSIFICATION, PERTINENT ANATOMY, AND SURGICAL LANDMARKS BY LEVEL
Level I(A/B)
Level II(A/B)
Level III
Level IV
Level V(A/B)
Level VI
Level VII
Posterior Neck
INDICATIONS AND SURGICAL TECHNIQUE OF SELECTIVE NECK DISSECTION
Supraomohyoid (Levels I–III) Neck Dissection
Lateral (Levels II–IV) Neck Dissection
Posterolateral (Levels II–V, Suboccipital, and Retroauricular) Neck Dissection
Central Neck Dissection (Levels VI–VII)
COMPLICATIONS
Hematoma
Chylous Fistula
Seroma
Wound Infection
Carotid Artery Rupture
Shoulder Syndrome
Internal Jugular Vein Occlusion
Submandibular Gland Prolapse
Hypoparathyroidism and Recurrent Laryngeal Nerve Injury
POSTOPERATIVE CARE
CONCLUSION
SECTION 5: THYROID
CHAPTER 19:
Thyroidectomy
INTRODUCTION
ANATOMY AND EMBRYOLOGY
INDICATIONS AND CONTRAINDICATIONS FOR SURGERY
SURGICAL TECHNIQUE
Minimally Invasive Approaches
Substernal Goiter
COMPLICATIONS
Recurrent Laryngeal Nerve Injury
Superior Laryngeal Nerve Injury
Hypoparathyroidism
Postoperative Bleeding
Infection
Seroma
CONCLUSION
CHAPTER 20:
Parathyroid Surgery
ANATOMY AND EMBRYOLOGY
INDICATIONS FOR PARATHYROIDECTOMY
PREOPERATIVE LOCALIZATION STUDIES
OPERATIVE TECHNIQUES
Parathyroid Exploration
Minimally Invasive Parathyroidectomy
Minimally Invasive Radioguided Parathyroidectomy
Ultrasound-Guided Parathyroidectomy
Video-Assisted Parathyroidectomy
Intraoperative PTH Monitoring
POSTOPERATIVE CARE AND COMPLICATIONS OF PARATHYROIDECTOMY
Hypocalcemia
Recurrent Laryngeal Nerve Injury
SECTION 6: SALIVARY AND PARAPHARYNGEAL SPACE TUMORS
CHAPTER 21:
Parotidectomy
INTRODUCTION
ANATOMY4
Gland Structure
Vascular Anatomy
Nerve Anatomy
PAROTIDECTOMY—INDICATIONS AND CONTRAINDICATIONS
Indications
Contraindications
SPECIAL CONSIDERATIONS: NERVE MONITORING
INSTRUMENTS AND OPERATIVE CONSIDERATIONS
TECHNIQUE: INCISIONS
TECHNIQUE: SKIN FLAP ELEVATION
TECHNIQUE: FACIAL NERVE IDENTIFICATION
Tips on Nerve Identification
TECHNIQUE: RECONSTRUCTION
SUPERFICIAL PAROTIDECTOMY12
TOTAL PAROTIDECTOMY
COMPLICATIONS
CHAPTER 22:
Submandibular Gland Excision
SURGICAL INDICATIONS—SUBMANDIBULAR GLAND EXCISION
SURGICAL TECHNIQUE—SUBMANDIBULAR GLAND EXCISION
SURGICAL COMPLICATIONS—SUBMANDIBULAR GLAND EXCISION
CHAPTER 23:
Tumors of the Parapharyngeal Space
INTRODUCTION
ANATOMY
PRESENTATION
EVALUATION
TUMORS
Carotid Body Tumors
Glomus Vagale Tumors
SURGICAL APPROACHES
Transoral Approach
Transcervical Approach
Transcervical Submandibular Approach
Transcervical Submandibular Approach with Mandibulotomy
Transcervical Transparotid Approach
SUMMARY
CHAPTER 24:
Surgery for Carotid Body Paraganglioma
INTRODUCTION
EPIDEMIOLOGY
PRESENTATION
SURGICAL ANATOMY
RADIOGRAPHIC EVALUATION
FURTHER EVALUATION
MANAGEMENT
Surgical Management
Surgical Approaches
Nonsurgical Management
Radiation
CONCLUSION
SECTION 7: SURGERY FOR SKIN CANCER
CHAPTER 25:
Surgical Management of Nonmelanoma Cutaneous Malignancies of the Head and Neck
INTRODUCTION
Basal Cell Carcinoma
Cutaneous Squamous Cell Carcinoma
Merkel Cell Carcinoma
Dermatofibrosarcoma Protuberans
TREATMENT
Preoperative Evaluation
Indications
Surgical Technique
Complications
Postoperative Care
CONCLUSION
CHAPTER 26:
Surgical Management of Cutaneous Melanoma of the Head and Neck
INTRODUCTION
TREATMENT
PREOPERATIVE EVALUATIONS
INDICATIONS
SURGICAL TECHNIQUE
Primary Resection
Management of Lymph Nodes
COMPLICATIONS
POSTOPERATIVE AND FOLLOW-UP CARE
CONCLUSION
INDEX
TOC
Index
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