Surgery Of Head And Neck Tumors【2025|PDF|Epub|mobi|kindle电子书版本百度云盘下载】

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PART 1-BASIC PRINCIPLES OF CANCER SURGERY OF THE HEAD AND NECK1

1 Historical Notes3

Recent Advances Permitting Relatively Safe Radical Surgery of the Head and Neck13

2 Preoperative Considerations14

Planning the Operation—Selection of the Operative Procedure14

Local as Compared to Total Excision of an Organ or an Anatomic Part15

Resection of an Adjacent Anatomic Structure15

Excision of Bone16

Extraction of Teeth16

Preoperative Working Models for Postoperative Prostheses16

Extent of Neck Dissection16

The＂Forgotten Zone＂17

Combination of Neck Dissection with Excision of Primary Lesion18

Excision of Primary Lesion Leaving an Open Defect for Later Closure18

Medical Work-up18

The Problem of Operative Risk18

The＂Noli me Tangere＂in Head and Neck Surgery19

Age in Relation to Operative Mortality20

Biopsy21

Punch Biopsy21

The Problem of the＂Lump in the Neck＂21

Aspiration Biopsy29

Technic of Aspiration Biopsy29

Frozen Section33

3 The Operation—Technical Considerations35

Shaving and Sterile Preparation of the Operative Field35

Anesthesia36

Nerve Block or Regional Anesthesia37

Hypotensive Anesthesia38

Free Airway for Duration of Anesthesia and Measures to Prevent Aspiration of Blood33

Endotracheal Tube with Packing in Pharynx38

Endotracheal Tube with Inflatable Cuff38

Simple Tracheostomy with Packing in Pharynx38

Tracheostomy Tube with Inflatable Cuff41

Balloon Cuff Anesthesia Tube41

Position of the Patient on Operating Table41

Draping of the Patient41

Selection of Instruments for an Operation44

Nomenclature of Operative Procedures44

Names of Specific Instruments44

Blood Transfusions45

Skin Incision and Operative Exposure45

Hemostasis，Ligatures，and Knot-Tying：Endothermy48

Specific Reasons for the Excision of Bone in Head and Neck Surgery49

Invasion of Bone by Cancer49

For Access to Operative Site49

To Permit Shifting of Soft Tissues to Facilitate Closure49

Form and Extent of Mandibular Bone Excision50

Partial or Complete Excision of the Hyoid Bone50

Partial Resection of the Clavicle50

Peripheral and Deep＂Safe＂Margins for Excision of Cancer50

Cosmetic Appearance and Restoration of Function versus Adequately Wide Excision of Cancer51

Closure of Operative Wounds of the Head and Neck51

The＂Pull-Through＂Technic53

Ligation by Wire of the Residual Stump in Cystic Cervical Lymph-hygroma53

Isolation of the Oral Cavity by Primary Closure of the Pharyngeal Opening54

Marsupialization of Benign Bone Cysts54

Exploratory Laryngofissure in Cancer of the Intrinsic Larynx54

Resection of a Thyroid Lobe to Facilitate Surgery in the Root of the Neck55

Various Reconstructive Procedures55

Skin Grafts for Operative Defects of the Maxilla，Orbit，and Mouth55

Skin Grafts on Stents for Closure of Annular Pharyngeal Defects56

Rotated or Sliding Flap Grafts57

Skin Grafts for the Repair of Superficial Facial Defects58

Tubed Pedicle Grafts58

Bone Grafts59

Buried Metal Splints60

Limitations in Usefulness of Bone Gratts and Metal Splints for Mandibular Defects60

Fixation of the Mandible by Bite Block or by Wiring the Teeth60

Surgical Prosthesis61

Wound Drainage62

Sump Suction Drainage63

Essential and Prophylactic Tracheostomy63

Tracheostomy Trocar for Acute Respiratory Obstruction67

Prophylactic Arterial Ligations68

Surgery After Radiation Therapy68

4 Postoperative Care71

Recovery from Anesthesia—Management of Endotracheal Breathing Tube71

Immediate Pressure Dressings71

Air Cushion Pressure Dressings72

Pressure Dressings over Skin Grafts and Rotated Pedicle Flaps72

Early Ambulation74

Prevention and Control of Postoperative Sepsis74

Antibiotics74

Zinc Peroxide74

Bacillus Pyocyaneus Infections74

Care of the Tracheostomy74

Nutritional Care76

Liquid Diets for Naso-esophageal Tube Feeding77

Minor Role of Gastrostomy in Head and Neck Cancer78

5 Immediate Operative Risk and Functional Disability Following the Sacrifice of Specific Anatomic Structures of the Head and Neck79

Jugular Veins79

External Carotid Arteries80

Common or Internal Carotid Artery80

Arterial Grafts and Vascular Anastomoses81

Subclavian Artery81

Recurrent Laryngeal Nerve82

Superior Laryngeal Nerve82

Phrenic Nerve83

Seventh Cranial Nerve83

Vagus Nerve84

Hypoglossal and Lingual Nerves84

Cervical Sympathetics84

Carotid Sinus Syndrome84

Horner＇s Syndrome85

Exposure of Dura and/or Cerebral Cortex85

Sacrifice of Eye86

Submaxillary and Parotid Ducts86

Thyroid and Parathyroid Glands87

Thoracic Duct87

6 General and Local Complications of Head and Neck Surgery88

Shock88

Hemorrhage88

Gastrointestinal Hemorrhage89

Hematoma and Chyloma90

Hematoma in Thyroid Surgery90

Chyloma90

Subcutaneous Emphysema91

Infection—Wound Sepsis91

Separation of the Suture Line within the Mouth91

Influence of Diabetes or Liver Dysfunction on Wound Healing92

Pulmonary Complications—Respiratory Obstructions92

Pneumothorax and Pneumomediastinum—Air-Sucking Wounds in the Neck92

Malnutrition—Dysphagia—Dysmaseis—Dysgeusia94

Lymphedema95

Postoperative Granuloma of the Larynx and Trachea95

Granuloma Following Partial Laryngectomy96

Granuloma Following Intubation96

Granuloma of the Trachea following Tracheostomy96

Stricture(Anterior Webbing)of the Glottis Following Partial Laryngectomy96

Anterior Webbing97

Salivary Fistula—Pharyngostome97

Temporary Pharyngostome97

Trismus97

Corneal Injuries and Other Eye Complications98

Tracheitis Sicca99

Microstomia Following Total Laryngectomy99

Inflammatory and Traumatic Hypertrophy of the Tail of the Parotid Following Neck Dissection100

Keloid101

Treatment101

7 Long-Term Cosmetic and Functional Disabilities Following Radical Surgery of the Head and Neck102

Cosmetic Appearance102

Disability and Paresthesias Following Neck Dissection Due to Section of the Eleventh Cranial Nerve and Cervical Plexus103

Tissue Defects of the Mouth Producing Salivary Incontinence103

Dysphagia and Masticatory Difficulties104

Speech Disabilities104

Speech Re-education104

The Reed Larynx104

The Electro-larynx104

Esophageal Voice105

BIBLIOGRAPHY107

PART 2-ATLAS OF OPERATIVE PROCEDURES117

8 Operative Procedures of a General Character or Application119

Neck Dissection119

Segmental Excision of the Common Carotid Artery and End-to-End Anastomosis127

Maneuver to Avoid Inadvertent Injury to the Marginalis Mandibulae Nerve During Neck Dissection128

Combination Neck Dissection and Axillary Dissection129

Excision of Submaxillary Salivary Gland(Submaxillary Dissection)130

Excision of Congenital Cervical Cysts and Fistulae131

Thyroglossal Duct Cyst131

Branchiogenic Cyst134

Branchiogenic Fistula135

Tracheostomy136

Ligation of External Carotid Artery140

Ligation of Parotid Ducts142

Anterior Pharyngotomy143

Fusion of Eyelids145

Formation of Tubed Pedicle Grafts146

Migration of Tubed Pedicle Grafts148

Migration to Defects in the Submental Area150

Migration to Lateral Cheek Area151

Migration to Lateral Face Area153

Donor Sites for Skin Grafts for Facial Defects156

Pinch Grafts as an Aid to Incompletely Closed Incisions158

Reduction in Size of Circular Defects by Purse-String Sutures Before Skin Grafting159

9 Operations for Cancer of the Skin of the Face(Eyelids，Nose，Lip，and Ear)161

General161

Elliptical Incisions for Excision of Small Cancers of the Face161

Eyelids163

Excision of Small Growth of Upper Eyelid by Simple Ellipse163

Excision of Growth of the Upper Eyelid Approaching the Palpebral Margin—Closure by Rotated Flap from Adjacent Upper Eyelid164

Closure of Upper Eyelid Defect by Rotated Flap from the Temporal Area165

Circular-Shaped Excision with Z-Plastic Closure for Growth near Palpebral Margin166

Wedge-Shaped Excision of Growth of Palpebral Margin167

Excision of Growth Below the Inner Canthus；Closure by Rotated Flap from the Upper Eyelid168

Excision of Growth of the Lower Eyelid；Closure by Rotated Flap from the Upper Eyelid169

Excision of Growth of Lower Eyelid near Outer Canthus；Closure by Rotated Flap from the Upper Eyelid170

Rotated Flap from Nasolabial Groove for Closure of Defects of Lower Eyelid171

Temple and Cheek172

Excision of Growth of the Temporal Region；Closure by Skin Graft172

Excision of Growth of the Skin of the Cheek；Closure by Full-Thickness Skin Graft173

Closure of Large Cheek Defect by Split Graft174

Excision of Growth of the Skin of the Cheek；Closure by Rotated Flap from the Temporal or the Mastoid Area175

Nose176

Excision of Growth of Bridge of the Nose；Closure by Direct Suture176

Excision of Growth Near Tip of Nose：Closure by Skin Graft and Sandwich-Type Pressure Dressing177

Excision of Growth of Nasal Ala；Closure by Rotated Flap from Cheek178

Excision of the Full Thickness of the Margin of the Nasal Ala；Repair by a Doubled Rotated Flap179

Excision of Growth Near Tip of Nose；Closure by Rhinoplasty180

Radical Excision of the Nose and Nasal Cavity for Deeply-Invasive Cancer of the Skin of the Nose183

Lips184

Excision of Growth of the Upper Lip；Closure by Rotated Flaps184

Excision of Growth of the Skin of the Upper Lip；Closure by Sliding Flap185

Excision of Skin Cancer of Lower Lip；Closure by Skin Graft and Mattress-Suture Pressure Dressing186

Chin187

Excision of Radiation Sclerosis and Cancer of Skin of Chin and Repair by Pedicle Tube Graft187

Ear189

Excision of Growths in and About Auricle189

Excision of Growths in the External Auditory Canal191

Radical Excision of External and Middle Ear with Skin Graft193

10 Operations for Cancer of the Mucosa of the Lip195

Local Excision of Cancer of the Lip by Simple Ellipse196

V-Excision of Lower Lip197

Subtotal Excision of Mucosa of the Lower Lip(Lip-Stripping Operation)198

Combined V-Excision and Lip-Stripping Operation200

Estlander Cheiloplasty201

Bridged Cheiloplasty for Cancer of the Lower Lip201

Homolateral Nonbridged Estlander Cheiloplasty203

Bernard Cheiloplasty for Advanced Cancer of the Lower Lip204

Bridged Estlander Cheiloplasty for Cancer of the Upper Lip206

Cheiloplasty for Cancer of the Upper Lip；Closure by Bilateral Sliding Flaps207

11 Operations for Cancer of the Mucosa of the Cheek209

Local Excision of Cancer of Mucosa of Cheek and Closure by Simple Suture210

Irregularly-Shaped Excision of Cancer of Mucosa of Cheek211

Excision of Tumor of the Mucosa of the Cheek；Closure by Skin Graft212

Excision of Widespread Multiple Cancer or Precancer of the Mucosa of the Cheek，Lips，Gum，and Palate：Closure by Skin Graft on Prothesis and on Buried Stents214

Excision of Posterosuperior Buccal Tumors Through Weber-Fergusson Approach217

Through-and-Through Excision of Cancer of the Cheek and Closure by Estlander Flap219

Excision of Deeply-Infiltrating Tumor of the Buccal Mucosa Combined with Neck Dissection：Access to the Cheek by Splitting the Lower Lip220

Through-and-Through Excision of Advanced，Deeply-Infiltrating Cancer of the Cheek Combined with Neck Dissection223

12 Operations for Cancer of the Gum225

Local Excision of a Small Cancer of the Edentulous Gum226

Excision of Cancer of the Gum and Closure by Lateral Shifting of the Floor of Mouth228

Marginal Resection of Mandible(Alveolar Process)for Cancer of the Gum229

Marginal Excision of the Lower Alveolus and a Portion of the Ascending Ramus for Cancer of the Retromolar Area(Combined with Neck Dissection)231

Excision of Cancer Involving Both Upper and Lower Gums and Retromolar Area by Partial Resection of the Mandible and Neck Dissection234

Variation in Procedure when Cancer of the Gum Involves the Edge of the Tongue238

13 Operations on the Mandible：For Primary Tumors of Bone；For Temporary Section of the Mandible；Hemimandibulectomy241

Hemimandibulectomy242

Resection of Ramus for Primary Bone Tumor245

Temporary Section of the Mandible for Approach to the Pterygomaxillary Space247

Resection of the Mandible Through the Open Mouth249

14 Buxied Metal Splints and Bone Grafts for Mandibular Defects251

Wire Mesh Splints251

Partial Resection of Mandible and Repair by Wire Mesh Splint252

Partial Resection of Mandible and Repair by Wire Mesh Splint：Variation in Method of Attaching Wire Mesh Splint255

Resection of the Mandible and Repair by Wire Mesh Splint：Variation in Position—Anterior Portion of Mandible256

Total Resection of Mandible with Replacement by Wire Mesh Spiint257

Bone Grafts259

Rib Grafts259

Iliac Crest Grafts261

15 Operations on the Tongue265

Local Excision266

Lesions on the Lateral Border266

Lesions on the Dorsum267

Lesions through Vertical Ellipse268

Partial Glossectomy269

Growths at the Tip，Lateral Border，or Dorsum of the Tongue269

Lesions on the Undersurface Near the Tip of the Tongue270

Superficial Lesions Involving the Tip and Most of the Dorsum of the Tongue271

Base of the Tongue Via Anterior Pharyngotomy274

With Resection of the Mandible and Neck Dissection275

Subtotal Glossectomy Combined with Neck Dissection277

16 Operations for Growths of the Floor of the Mouth281

Simple Elliptical Excision for Superficial Cancer282

Marginal Resection of the Mandible for Cancer of the Anterior Floor283

Excision of Cancer of the Anterior Floor Combined with Marginal Resection of the Mandible and Neck Dissection286

The＂Pull-Through＂Operation：Marginal Resection of the Mandible for Cancer of the Lateral Floor of the Mouth Combined with Neck Dissection288

Excision of Extensive Primary Cancer of the Floor Combined with Partial Resection of the Mandible and Neck Dissection290

Excision of Salivary Cyst(Rannula)294

17 Operations for Tumors of the Palate295

Excision of Small Tumor of the Hard or Soft Palate and Closure by Secondary Intention296

Excision of Superficial Warty Benign Tumors of the Hard Palate and Closure by Skin Graft297

Excision of Deeply-Infiltrating Tumors of the Hard Palate on or Invading the Bone298

Excision of Moderate-Sized Tumor of the Upper Gum and Palate299

Partial Excision of Maxilla and Palate for Osteogenic Tumors300

18 Operations for Tumors of the Nasal Cavity303

Lateral Rhinotomy304

Approach to the Nasal Cavity Through the Alveolar Process via Antrostomy305

Snare Removal of Polypoid Nasopharyngeal Tumors308

19 Operations on the Antrum and Maxilla311

Partial Resection of the Maxilla for Early Cancer of the Antrum312

Radical Resection of the Maxilla for Advanced Cancer of the Antrum and Paranasal Sinuses315

20 Operations for Parotid Tumors321

Some Cardinal Principles of Tumor Surgery of the Parotid Gland321

Excision of Small Peripherally-Placed Parotid Tumors322

Surgical Anatomy of the 7th Nerve323

Superficial Parotidectomy324

Excision of Retromandibular Tumors327

Excision of Bulky Benign Parotid Tumors330

Subtotal Parotidectomy with Preservation of the 7th Nerve332

Total Parotidectomy with Preservation of the 7th Nerve333

Subtotal Parotidectomy with Partial Preservation of the 7th Nerve Combined with Neck Dissection334

Total Parotidectomy with Complete Sacrifice of the 7th Nerve Plus Neck Dissection335

21 Operations on the Larynx337

Variations in Form and Extent of Laryngeal Surgery for Cancer337

Partial Laryngectomy338

Through Laryngofissure340

Through Anterior Pharyngotomy344

Total Laryngectomy345

Total Laryngectomy Combined with Neck Dissection353

Variations in Management of Wide Pharyngostome Following Pharyngolaryngectomy358

Pharyngolaryngectomy Combined with Neck Dissection361

Maneuver to Obtain Direct Exposure and Visualization of the Vallecula and of the Base of the Tongue362

Total Laryngectomy with Bilateral Neck Dissection365

Subtotal Laryngectomy Combined with Neck Dissection for Postcricoid Cancer371

Subtotal Laryngectomy Combined with Neck Dissection for Unilateral Cancer of the Extrinsic Larynx and/or Lateral Pharyngeal Wall376

Repair of Pharyngeal Defect by Split-Skin Graft on Latex Stent381

Z-Plastic for Enlargement of Microstomia Following Total Laryngectomy384

Delayed Closure of a Pharyngeal Stoma Following Total Laryngectomy385

Closure of Pharyngostome by＂Trap-Door＂Plastic386

Closure of Large Pharyngeal Stoma by Tubed Pedicle Flap387

Excision of Esophageal Diverticulum389

22 Operations for Growths of the Pharyngeal Walls391

Excision of Small Tumor of the Pharyngeal Wall Through Anterior Pharyngotomy392

Removal of Extensive Cancer of the Posterior Wall Through Anterior Pharyngotomy：Closure by Secondary Intention393

Removal of Submucous Bulging Tumor of Posterior Pharyngeal Wall394

23 Operations for Thyroid Tumors397

Hemithyroidectomy(Lobectomy)398

Thyroidectomy and Neck Dissection401

Window Resection of the Trachea for Invasion by Thyroid Cancer406

Substernal Thyroid Tumors408

Appendix415

Index425