Head and Neck Surgery: Surgical Landmark and Dissection Guide

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