Tumors of the head and neck continue to pose challenges for afflicted patients and their treating physicians. Because the complex and vital anatomy often involved affects the ability to communicate and interact socially, head and neck tumors can have a devastating effect on the patient’s quality of life. Due to the inherently complex nature of such tumors and their rarity, a comprehensive textbook devloted to their management is certain to be useful.
This textbook, edited by Thawley, Panje, Batsakis, and Lindberg, logs in at just under 2,000 pages divided between two volumes. Major sections include: an introductory section focusing on general management considerations; separate sections on tumors of the ear, nasal cavity/paranasal sinus, oral cavity, pharynx, larynx, salivary gland, skin, neck, craniofacial skeletal-dental, thyroid/parathyroid, and trachea; and a final section featuring special topics, such as head and neck tumors in children.
Each part of the book dedicated to a specific anatomic location begins with a chapter on the pathologic evaluation and classifications of tumors of that site. This is indeed a real benefit and highlight of the text, written under the direction of Dr. Batsakis, a universally noted expert in head and neck tumor pathology. Sections generally follow with additional chapters on surgical management, radiation treatment, and, when deemed appropriate, other relevant topics.
Each section ends with an interesting chapter summarizing controversies in the management of specific tumor sites of the head and neck. These “controversies” chapters, along with the pathology chapters, should be very useful to the intended audience of this textbook.
The multidisciplinary nature of the text and its contributing authors lends to its interesting, helpful perspectives on the management of sometimes very complex clinical problems. However, it also contributes to some redundancy in the text.
Additional highlights of the text that should prove useful to readers include the general considerations section, particularly the chapters on nursing care and molecular biology of head and neck tumors.
In a text that is overall very useful, a few shortcomings stand out: Some discussion of diagnostic techniques, such as fine-needle aspiration and office endoscopy, would have added to the “comprehensive” nature of the book. Chapter 27, on surgical therapy of tumors of the nasal cavity, provides no information on telescopic or endoscopic management of sinonasal tumors and discusses the somewhat outdated “Gigli” saw for the performance of maxillectomy osteotomies. Also, the text would have benefited from some discussion of midfacial degloving and LeFort I osteotomies for nasal cavity and sinus tumors, and, from a surgeon’s standpoint, the section on tumors of the salivary gland would have benefited from more details on rehabilitation, focusing on facial nerve deficits.
Additional sections that might have made the text more comprehensive include discussions of radiation-induced wound complications and reconstruction techniques, particularly, advanced microvascular flap reconstruction.
Notwithstanding these relatively minor shortcomings, the textbook presents a tremendous amount of useful information in an easily accessible format. I would recommend strongly that all training programs in surgical, medical, and radiation oncology, as well as allied specialties that commonly deal with head and neck tumor patients, have this text available for reference. The head and neck practitioner will similarly find this a useful and voluminous source of information for quick reference. The editors are to be acknowledged for their significant contribution and encouraged to continue refining and expanding their work.
A 52-year-old man presented with an erythematous lesion in the axilla of unknown duration. Surgical excision was performed. What is your diagnosis?
