By Nirav Trivedi
Surgical procedure for head neck melanoma has advanced enormously within the contemporary years. acceptable surgical resection with destructive margins nonetheless stay corner-stone in attaining sturdy oncological end result. This atlas proposes a brand new proposal of " The Compartment surgical procedure " to accomplish detrimental margins in 3rd dimensions that is the matter zone in majority of instances. Reconstructive strategies have advanced tremendously within the fresh years with use of microvascular loose flaps and this has considerably more desirable the useful end result. appearing every one step in applicable demeanour cumulatively permits us to accomplish extra complicated systems. subject of this atlas revolves round this fact.
This atlas on head and neck cancers takes a clean stylistic technique the place every one surgery is defined in a step-wise demeanour via classified high-resolution photographs with minimum incorporation of textual content. this enables the surgeons to quickly revise the operative steps of a strategy inside of mins earlier than they begin a surgical procedure. Head and neck has multidimensional anatomy and surgical procedure calls for particular technique for every subsite. This operative atlas covers the whole spectrum of universal, unusual and infrequent cancers of the top and neck quarter. each one subsite is addressed in a separate bankruptcy with extra subdivisions for surgical procedure of tumors with various quantity. every one technique is established with images of every surgical step and line diagrams. favourite flaps (regional and unfastened flaps) are validated in separate bankruptcy for reconstruction. With over a thousand pictures, and insurance of either the ablative and reconstructive surgeries, this can be a technique-focused atlas compared to the on hand finished texts. There are chapters on very complicated cancers, and surgical procedure in source restricted surgical devices making the ebook suitable to a variety of melanoma surgeons and fellows-in-training in different medical settings.
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Additional info for Atlas of Head and Neck Cancer Surgery: The Compartment Surgery for Resection in 3-D
It is preferred to mobilize both the upper and lower ends of the trachea before beginning the anastomosis Fig. 28 The photogaph shows the technique to mobilize the upper half. This technique is similar to what we do in laryngectomy to expose the vallecula region. Suprahyoid muscles are released from the hyoid bone. This will help us to drop down the hyoid–thyroid cartilage unit and gain about 3–5 cm extra length Thyroid 27 Fig. 29 Shows mobilization of the lower trachea. It is very important to preserve the blood supply of the trachea by not disturbing the lateral blood supply to the trachea and keeping the perichondrium intact.
The headgear shown in Fig. 34 is very heavy and not commonly used now. In case of accident leading to shearing of tracheal anastomosis, one should open the wound and try to secure the lower end of the trachea and airway. Patient can be taken to the theater and managed accordingly 3 Tumors of the Thyroid and Parathyroid Thyroid Thyroidectomy with Sternotomy for Retrosternal Goiter The majority of retrosternal goiters can be removed from the neck by subcapsular dissection. Very few actually require sternotomy.
34 Very advanced disease with involvement of temporal bone Fig. 37 Placement of brachytherapy catheter to address residual lesion. With advent of intensity-modulated radiation therapy (IMRT), the use of brachytherapy has become limited, but we still use it for cases where there is gross residual disease left. These patients are in miserable state and we have a policy to attempt surgical clearance with aggressive adjuvant therapy. This provides the best care to the patient in this situation Fig.