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Malignant Lesions of the Head and Neck 1
Robert T. Sataloff, MD, is a professor of otolaryngology, head and neck surgery at Jefferson Medical College and an adjunct professor of otorhinolaryngology at the University of Pennsylvania. Here, he discusses the prevalence and risk factors for primary malignant neoplasms of the head and neck, the principles of diagnoses and the current guidelines for treatment. Some 80% of primary head and neck malignancies are squamous cell carcinomas. The author describes the symptoms associated with a diagnosis of cancer and stresses the importance of family history and nutritional status when evaluating patients. Dr. Sataloff provides anatomy and physiology of the head and neck, noting that physical examination includes fiberoptic examination of nasopharyngeal and hypopharyngeal areas and palpation of the oral cavity. In evaluating a neck mass, he says, MRI and CT scan are indicated along with laryngoscopy, esophagoscopy, bronchoscopy and nasopharyngoscopy. Surgery is the treatment of choice for many patients although dysphagia associated with head and neck malignancy can increase surgical morbidity and mortality. While radiation therapy is adequate treatment for early lesions, says the author, mucositis, xerostomia and soft tissue fibrosis and necrosis may be complications. Cancer of the nasal cavity and paranasal sinuses occurs mainly in the maxillary sinuses and is treated by subtotal or radical maxillectomy. Treatment for epithelial nasopharyngeal tumors is radiation. The lecture provides guidance on post-surgical rehabilitation which includes a variety of surgical flaps. In addition, the lecture is supported by more than 60 illustrations. Read More from Dr. Sataloff and the Journal of Voice. |
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