1. Disorders of the head and neck can cause significant
cosmetic and functional impairment. The practitioner must be empathetic
to the effect of these morbidities on quality of life.
2. Infectious conditions of the head and neck may present with life-threatening
sequelae such as loss of airway or intracranial extension.
3. Patients with obstructive sleep apnea require evaluation to determine
the specific anatomic site(s) of involvement. Long-term cardiovascular problems
are a significant concern in these patients.
4. Repair of traumatic soft-tissue injuries requires precise realignment
of anatomic landmarks such as the gray line and vermilion border.
5. The key principle in the surgical repair of facial fractures
is immobilization, which may require plates, screws, wires, and/or
6. Concurrent abuse of tobacco and alcohol are synergistic in increasing
the risk of developing head and neck cancer.
7. Hoarseness, a nonhealing oral ulcer, or cervical lymphadenopathy
of greater than 2 weeks duration requires evaluation.
8. Monomodality therapy (surgery or radiation) is used for early
stage (I/II) head and neck cancer, whereas combination
surgery and chemoradiation is used with advanced stage (III/IV)
9. The most significant recent advance in the treatment of head
and neck cancer is the use of epidermal growth factor receptor inhibitor-based
The head and neck constitute a complex anatomic region where different
pathologies may affect an individual’s ability to see,
smell, hear, speak, obtain nutrition and hydration, or breathe.
The use of a multidisciplinary approach to many of the disorders
in this region is essential in an attempt to achieve the best functional
results with care. This chapter reviews many of the common diagnoses
encountered in the field of otolaryngology-head and neck surgery
and aims to provide an overview that clinicians can use as a foundation
for understanding of this region. As is the case with every field
of surgery, care for patients with disorders of the head and neck
is constantly changing as issues of quality of life and the economics
of medicine continue to evolve.
Infections may involve the external, middle, and/or
internal ear. In each of these scenarios, the infection may follow
an acute or chronic course and may be associated with both otologic
and intracranial complications. Otitis externa typically refers
to infection of the skin of the external auditory canal (EAC).1 Acute
otitis externa is commonly known as swimmer’s ear,
because moisture that persists within the canal after swimming often
initiates the process and leads to skin maceration and itching.
Typically, the patient subsequently traumatizes the canal skin by
scratching (i.e., with a cotton swab or fingernail), thus eroding
the normally protective skin/cerumen barrier. Because the
environment within the external ear canal is already dark, warm,
and humid, it then becomes susceptible to rapid microbial proliferation
and tissue cellulitis. The ...