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Atlas ofHead Neck
and Skull-base
Surgery
NitinMNagarkar
RupaMehta
AmbeshSingh
KarthikNRao
PrajwalSDange
Editors
123
Atlas of Head Neck and Skull-base
Surgery
Nitin M Nagarkar • Rupa Mehta
Ambesh Singh • Karthik N Rao
Prajwal S Dange
Editors
Atlas of Head Neck
and Skull-base Surgery
Editors
Nitin M Nagarkar
SRM Medical College Hospital and
Research Centre
SRMIST, Kattankulathur, Chengalpattu
Tamil Nadu, India
Ambesh Singh
All India Institute of Medical Sciences
Raipur, Chhattisgarh, India
Prajwal S Dange
All India Institute of Medical Sciences
Raipur, Chhattisgarh, India
Rupa Mehta
Department of ENT
All India Institute of Medical Sciences
Raipur, Chhattisgarh, India
Karthik N Rao
All India Institute of Medical Sciences
Raipur, Chhattisgarh, India
ISBN 978-981-99-6131-3 ISBN 978-981-99-6132-0 (eBook)
https://doi.org/10.1007/978-981-99-6132-0
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Singapore Pte Ltd. 2023
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher,
whether the whole or part of the material is concerned, specically the rights of translation,
reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microlms or in any
other physical way, and transmission or information storage and retrieval, electronic adaptation,
computer software, or by similar or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specic statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in
this book are believed to be true and accurate at the date of publication. Neither the publisher nor
the authors or the editors give a warranty, expressed or implied, with respect to the material
contained herein or for any errors or omissions that may have been made. The publisher remains
neutral with regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Singapore Pte Ltd.
The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore
189721, Singapore
Paper in this product is recyclable.
To my wife Anu who has been by my side throughout our life
https://t.me/medicina_free
journey, whose love, endless support and encouragement have
made it all possible
To my son Rishabh, pillar of my strength, for his unconditional
love and support
To my teachers and colleagues, for their faith and
encouragement
To our patients and their families, for their trust at all times
NMN
To my parents and brother Hitesh for their unending love
To my husband, Harshal, and kids, Harshit and Rupansh, for
their immense support and understanding
To my teachers, patients and God Almighty, for constant
blessings
RM
To my parents, Mr. Tejveer Singh and Mrs. Gayatri Singh, and
brothers Durgesh Singh and Lokesh Jadon, whose constant
support and guidance have been invaluable to me
To my loving wife, Deepa Singh, and son Reyansh Singh, who
have been my source of inspiration and motivation throughout
this journey
To my teachers, patients and God Almighty, for constant
blessings
AS
To my pillar of strength, my loving wife, Sumedha
My source of inspiration, Appa and Amma
My supporting brother Kaushik
My ever-encouraging father-in-law and mother-in-law
KNR
To my ever-loving wife, Mona Yadav, and daughter, Nitara, for
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their endless love and encouragement
To my parents, Shrirang Dange and Vedavathi K.L., who gave
me everything and always seem to nd ways to give more; to
my brother Preetham for his support and to my father-in-law
and mother-in-law, Jaswant Singh and Dinesh Yadav, for their
unfaltering encouragement
PSD
Foreword
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The head and neck region is one of the most complex anatomical structures
in the human body. Being located between the heart and the brain, and incorporating the upper aerodigestive tracts, it is also the origin of various pathological processes of neoplastic, infectious or congenital origin. The head and
skull base were also among the last areas to be explored surgically. Throughout
the past decade, various treatments were developed for the management of
head and neck pathologies. The welcome infusion of new tools including
minimally invasive and robotic techniques has enabled safer and les morbid
surgical approaches to this region. To improve the outcome of patients,
microvascular techniques were developed which signicantly improved the
quality of life of patients. Hence, surgeons need a comprehensive easy-to-use
atlas that serves as a manual for the management of such patients.
Head and neck surgery is an intricate and demanding medical speciality
that requires a comprehensive understanding of human anatomy and physiology, as well as the technical skills and dexterity necessary to perform complex procedures with precision and care. As surgical techniques continue to
advance, it is crucial for practitioners to stay up to date with the latest developments and procedures.
Atlas of Head Neck and Skull Base Surgery uses a case-based approach to
highlight the commonly encountered cases to complex cases, making it an
easy and practical resource. It includes various sections, each focusing on a
different aspect of surgery. Each section covers general principles, including
patient evaluation, relevant preoperative investigations, surgical techniques
and post-operative care. The various sections discuss surgery of the cutaneous malignancies of the head and neck, thyroid gland, parathyroid gland, salivary glands, larynx and airway, oral cavity, nose and paranasal sinuses, skull
base lesions and neurogenic tumours of the neck.
This Atlas serves as an intraoperative step-by-step guide of the various
surgical approaches to the head and neck, without requiring prior knowledge
in the eld. It is meant to be accessible to residents, fellows and specialists in
various disciplines, including otolaryngology, head and neck surgery, neurosurgery, plastic and reconstructive surgery, maxillofacial surgery and oncology. Throughout, the emphasis is on the vision of interdisciplinary education
including the preoperative workup, surgical technique, post-operative complications and follow-up.
The Atlas is organized by anatomical region, with each section covering a
range of procedures commonly performed in that area. The procedures are
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presented in a self-explained format, with detailed descriptions of each step
accompanied by high-quality photographs to help readers visualize the surgical anatomy and techniques involved.
The Atlas is written by one of the renowned head and neck surgeon professors (Dr.) Nitin M Nagarkar and his efcient team of surgeons. Professor
(Dr.) Nitin M Nagarkar is among the most experienced head and neck surgeons in the world, and through this Atlas, he aims to provide a comprehensive resource material for head and neck surgical education and practice. The
authors also present and discuss the cases of varying complexities throughout, introducing all the major ideas that a physician involved in treating these
patients would be expected to know. This book contains not only the genesis
and pathogenesis of head and neck diseases, but also what all surgeons need
to bring about successful resolution of disease, with the return of normal
function.
I trust that this Atlas will serve as a valuable reference for those seeking to
enter or expand their knowledge and skills in surgical practice.
Professor ZivGil
Director, Department of Otolaryngology-Head & Neck Surgery
Rambam Medical Center
Haifa, Israel
Foreword
Preface
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It is with great pleasure that we present to you our book “Atlas of Head Neck
and Skull base Surgery: A Case-Based Approach”. This project has been a
long-standing dream of ours, and we are excited to share it with you.
The eld of head, neck and skull base surgery is constantly evolving, and
it is essential for surgeons to keep abreast with the latest evidence and techniques. This Atlas is designed to provide a comprehensive overview of the
various surgical procedures used in this speciality, including both ablative
and reconstructive approaches.
Our goal in creating this Atlas was to provide a resource that is both informative and accessible, which can help learners at all levels to gain a deeper
understanding of this subject.
The book is divided into several sections, each focusing on a different
aspect of head, neck and skull base surgery. Each section covers general principles, including patient evaluation, surgical technique and post-operative
care. The sections discuss surgery of the cutaneous lesions of the head and
neck, thyroid gland, parathyroid glands, salivary glands, larynx and airway,
oral cavity, nose and paranasal sinuses, skull base lesions and neurogenic
tumours of the neck. The nal section covers the reconstructive approaches to
head and neck defects, principles of adjuvant therapy and transoral robotic
surgery.
With a focus on multidisciplinary treatment, our Atlas showcases the latest
evidence-based practices and patient management techniques that are critical
for achieving the best possible outcomes. Pertinent high-quality references
have been cited in the manuscript. Each case is presented in a clear, concise
manner, with detailed descriptions of the surgical techniques employed and
the rationale behind them. Additionally, the book features state-of-the-art
management and follow-up strategies that are designed to optimize patient
outcomes and improve quality of life.
Our Atlas is a culmination of years of clinical experience and research. It
includes exhaustive illustrations, diagrams and photographs to aid our readers
to visualize and understand the complex nature of head and neck.
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We hope that this Atlas will be useful for residents, fellows and practitioners in the eld of head, neck and skull base surgery. It is our goal to educate
and inspire the next generation of head and neck surgeons to continue pushing the boundaries of what is possible in this exciting and rapidly evolving
speciality.
Chengalpattu, Tamil Nadu, India NitinMNagarkar
Raipur, Chhattisgarh, India RupaMehta
Raipur, Chhattisgarh, India AmbeshSingh
Raipur, Chhattisgarh, India KarthikNRao
Raipur, Chhattisgarh, India PrajwalSDange
Preface
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