Head & Neck Surgery
THYROIDECTOMY: The thyroid gland is an organ shaped as butturfly made up of two cone-like lobes or wings connected via isthmus. The gland regulates metabolism by secreting hormones. Types of thyroid removal surgery include:
• Hemithyroidectomy or lobectomy. This includes taking out one lobe (or half) of the thyroid. If a nodule or low-risk thyroid cancer is limited to one side of the thyroid the doctor may suggest this surgery.
• Isthmusectomy. In this surgery the isthmus, a piece of tissue is removed that joins the two lobes of the thyroid. Small tumors on the isthmus may only need an isthmusectomy.
• Total thyroidectomy. This involves removing the entire thyroid gland. In some cases of thyroid cancer, bilateral thyroid nodules, and Graves’ disease needed a full thyroidectomy.
PARATHYROIDECTOMY : Parathyroidectomy is the operation in which one or more parathyroid glands are removed.
The parathyroid glands are four rice-sized glands detected on back of the thyroid gland in the neck. The parathyroid glands make parathyroid hormone (PTH), which commands the levels of calcium in the body.
NECK DISSECTION (REMOVAL OF CANCEROUS NECK LYMPH NODES) A neck dissection is a surgery to remove lymph nodes from the neck. In the neck, lymph nodes are called cervical lymph nodes. This operation is also known cervical lymph node dissection or a cervical lymphadenectomy.
The lymphatic system aids to fight with infections and is made up of lymph vessels, lymph fluid, lymph nodes, bone marrow and the lymphatic organs (thymus, adenoid, tonsil and spleen). The lymph nodes are present as the part of lymphatic system.
Similar to blood vessels Lymph vessels are thin tubes. They assemble and take lymph fluid away from tissues into the lymph nodes. Lymph nodes are small organs of lymphatic tissue shaped as bean. It can bear cancer cells from where the cancer started into the lymph nodes. Lymph fluid can sometimes carry cancer cells into the cervical lymph nodes, with head and neck cancers,.
In the premature phases, you cannot feel the cancer in the lymph nodes. You may feel a lump in the neck as the lymph nodes in the neck get bigger, in more advanced phases of cancer. The surgeon may also remove other tissue in the area, depends on the type of neck dissection surgery,.
Where cancer is very likely to spread, selective neck dissection removes only those lymph nodes. How many and which lymph nodes are removed depends on the size and location of the primary tumour. To maintain proper function of the neck and shoulder, the muscle and nerve tissue around the lymph nodes are not removed. A selective neck dissection is also known as a functional neck dissection.
Lymph nodes from levels I to V are removed by modified radical neck dissection, but keeps one or more of the following – internal jugular vein, sternocleidomastoid muscle or spinal accessory nerve.
Radical neck dissection takes out almost all lymph nodes on one side of the neck as well as the internal jugular vein, sternocleidomastoid muscle and spinal accessory nerve.
LYMPH NODE BIOPSY
• PAROTIDECTOMY Parotidectomy is known as the removal of a part or all of the parotid gland on one side of the face. Considerating the anatomy of the facial nerve as it is related to the parotid gland is the key to understanding the surgery. Superficial parotidectomy: The parotid gland is artificially split into a apparent and deep lobe by the facial nerve that runs in a set plane in the middle of the gland. An apparent parotidectomy needs removal of the parotid gland superficial to the plane of the facial nerve. It is the common type of parotid surgery, a less than complete superficial parotidectomy, One that has still removed the whole tumor with negative margin, may also be mentioned to as a partial parotidectomy.
• Total parotidectomy: This needs to take out of the whole parotid gland, including the superficial and deep lobe. If the facial nerve is not included, this will need pointing out all of the branches and cautiously retracting them out of the way as meticulous dissection is executed.
• Radical parotidectomy: Along with resection of the facial nerve, this procedure is a total parotidectomy. An enlarged radical parotidectomy will include removal of additional structures as well, such as the temporal bone or the skin of face overlying the parotid gland.
SUBMANDIBULAR GLAND EXCISION. A submandibular gland resection is the removal of that gland, most often for the removal of a tumor, but it may be performed for benign conditions such as chronic infection secondary to salivary stone.
The submandibular gland is located in Level I of the neck, just underneath the jaw. The duct empties saliva into the floor of mouth. Removal of one submandibular gland does not affect your ability to make saliva in any noticeable way because there are so many other saliva-producing glands
BENIGN NECK MASSES