Thyroid Tumors

• Benign: Follicular adenoma, Hürthle cell adenoma, teratoma, thyroid nodules (solitary or multinodular goiter).
• Malignant:
  • Primary: Papillary carcinoma, follicular carcinoma, Hürthle cell carcinoma, medullary carcinoma, anaplastic carcinoma, lymphoma, sarcoma, squamous cell carcinoma.
  • Secondary (metastatic): From kidney, lung, colorectal, or breast cancer.
• Thyroid Surgery: Completion thyroidectomy, neck lymph node dissection, hemithyroidectomy, total thyroidectomy.

Benign Neck Diseases

• Congenital: Lymphangioma (simple, cavernous, cystic hygroma), midline dermoid cyst / epidermoid cyst / dermoid cyst / teratoid cyst, thyroglossal duct cyst, branchial cleft cyst, branchial cleft fistula, thymic cyst, hemangioma.
• Acquired: Ranula (sublingual gland cyst), laryngocele, pharyngeal pouch/cyst.
• Infectious Neck Masses: Peritonsillar abscess, parapharyngeal abscess, Ludwig's angina, tuberculous cervical lymphadenitis, HIV-related lymphadenopathy, cystic lymph node enlargement in parotid; other causes include toxoplasmosis, actinomycosis, cat-scratch disease, brucellosis, infectious mononucleosis.
• Parotid and Submandibular Gland Surgery: Total parotidectomy, radical parotidectomy, extended radical parotidectomy, submandibular gland excision.

Parapharyngeal Space Tumors

• Lymph node metastases (e.g., lymphoma, nasopharyngeal carcinoma).
• Salivary gland origin (parotid, prestyloid salivary rests, minor salivary glands).
• Lipoma, liposarcoma.
• Neurogenic (schwannoma, neurofibroma, neurosarcoma).
• Paraganglioma (chemodectoma): Vagal, carotid body, jugular glomus tumors.

Metastatic Neck Disease

• Neck Lymph Node Levels (standard classification):
  • Level I: Submental and submandibular.
  • Level II: Upper jugular.
  • Level III: Mid-jugular.
  • Level IV: Lower jugular.
  • Level V: Posterior triangle.
  • Level VI: Anterior central compartment (pretracheal/prelaryngeal).
• Common Primary Sites: Oral cavity, tongue, retromolar trigone, nasopharynx, hypopharynx, soft palate, base of tongue, tonsillar fossa, supraglottic larynx, hypopharyngeal pyriform sinus.
• N0 Neck: If risk of occult metastasis >20%, consider elective treatment.
• Occult Primary Tumor: Thorough investigation of primary site; if negative, perform neck dissection ± postoperative radiotherapy.
• Neck Dissection:
  • Incisions: Schobinger, McFee, hockey-stick (horizontal T), transverse, extended thyroid, H-shaped.
  • Types: Radical neck dissection, extended radical, modified radical, selective (e.g., supraomohyoid, extended supraomohyoid, lateral, posterolateral, anterior/central compartment).

Laryngeal Tumors

• Anatomic Subsites: Supraglottic, glottic, subglottic.
• Benign Tumors: Papilloma, hemangioma, chondroma, granular cell tumor, schwannoma, neurofibroma, adenoma, granular cell myoblastoma, paraganglioma, leiomyoma, rhabdomyoma, fibroma, lipoma.
• Malignant Tumors: Squamous cell carcinoma, verrucous carcinoma, adenocarcinoma, sarcoma, undifferentiated carcinoma.
• Presentation: Hoarseness, dyspnea, dysphagia, neck mass/swelling.
• Treatment:
  • Early tumors: CO₂ laser or endoscopic resection, radiotherapy.
  • Advanced tumors: Laryngectomy (various types) + postoperative radiotherapy, voice rehabilitation.

Hypopharyngeal Tumors

• Anatomic Subsites: Postcricoid region, pyriform sinus, posterior pharyngeal wall (squamous cell carcinoma most common); rare: leiomyoma, lipoma, fibrolipoma, leiomyosarcoma.
• Approximately 1/6 of patients develop lymph node metastases.
• Presentation: Dysphagia, odynophagia, hoarseness, throat pain, otalgia, weight loss.
• Treatment: Partial laryngopharyngectomy, total laryngectomy + reconstruction (pedicled flap, free flap, gastric pull-up), neck dissection (usually required), postoperative radiotherapy, voice rehabilitation.

Lip and Oral Cavity Tumors

• Anatomic Subsites: 93% of lip cancers on lower lip; oral cavity includes buccal mucosa, upper/lower alveolus/gingiva, hard palate, tongue, floor of mouth.
• Pathology: Squamous cell carcinoma, oral leukoplakia, lichen planus, Fordyce granules (ectopic sebaceous glands).
• Treatment Principles: Wide local excision + reconstruction ± postoperative radiotherapy.
• Surgical Techniques: Partial glossectomy, hemiglossectomy, subtotal/total glossectomy; reconstruction (pedicled flap, free flap, skin graft); mandibulotomy or pull-through approach for access; neck dissection commonly performed.
• Lip Surgery: Wedge excision, lip shave, Abbe flap switch, Bernard reconstruction, etc.

Oropharyngeal Tumors

• Anatomic Subsites: Anterior wall (base of tongue), lateral wall (tonsillar fossa), superior wall (soft palate), posterior wall.
• Surgical Techniques: Transoral excision, commando operation (composite resection), total glosso-laryngectomy, palatectomy; reconstruction (local flaps, pectoralis major flap, deltopectoral flap, free flap).

Nasal and Paranasal Sinus Tumors

• Tumor Types: Osteoma, chondroma, ossifying fibroma, fibrous dysplasia, hemangioma, inverted papilloma, hemangiopericytoma, meningioma, basal cell carcinoma, squamous cell carcinoma, adenocarcinoma, minor salivary gland tumors, malignant melanoma, esthesioneuroblastoma, osteogenic sarcoma, malignant fibrous histiocytoma, lymphoreticular neoplasms.
• Surgical Techniques: Local excision + primary closure (nasolabial flap, nasal bridge); excision + graft (nasal tip, lateral nose); excision + rotation flap (medial canthus, lateral nose); total rhinectomy, lateral rhinotomy (medial maxillectomy), partial maxillectomy, total maxillectomy, craniofacial resection.

Ear Tumors

• Anatomic Subsites: Auricle, external auditory canal, middle ear, mastoid, temporal bone.
• Tumor Types: Cholesteatoma, jugular foramen paraganglioma, osteoma, hemangioma, neurogenic tumors, squamous cell carcinoma, adenocarcinoma, melanoma, basal cell carcinoma, sebaceous carcinoma, paraganglioma, minor salivary gland tumors.
• Surgical Techniques: Excision of auricle/external canal tumor ± reconstruction ± skin graft; radical mastoidectomy, petrous bone resection.

Surgery for Sleep-Disordered Breathing

• Nasal: Septoplasty, submucous resection, turbinectomy/turbinoplasty, turbinate reduction (radiofrequency, coblation, laser).
• Nasopharyngeal: Adenoidectomy (transoral, endoscopic, microdebrider).
• Palatal: Tonsillectomy, adenotonsillectomy, interstitial radiofrequency, uvulopalatopharyngoplasty (UPPP), laser-assisted UPPP, palatal implants, palatal stiffening procedures.
• Hypopharyngeal/Tongue Base: Interstitial radiofrequency, hyoid suspension, tongue base reduction, genioglossus advancement.
• Maxillofacial: Genioglossus advancement, maxillomandibular advancement (MMA), distraction osteogenesis.

Common ENT Surgeries

• Otology:
  • Excision of auricular lesions (simple elliptical excision, circumferential excision + graft, advancement helical flap, postauricular flap, composite skin-cartilage graft).
  • Auricular keloid: Intralesional excision + postoperative steroid injection for good cosmesis.
  • Preauricular sinus excision, meatoplasty, ventilation tube insertion (grommet), tympanoplasty, ossiculoplasty, stapedectomy, mastoidectomy, cochlear implantation.
• Neurotology: Internal auditory canal/cerebellopontine angle lesion surgery, surgery for vertigo, temporal bone glomus tumor surgery.
• Rhinology: Nasal bone fracture reduction, maxillary sinus lavage/antrostomy, inferior turbinate reduction, septoplasty/septal perforation repair, rhinoplasty, functional endoscopic sinus surgery (FESS), external frontal/sinus approaches, midfacial degloving, lateral rhinotomy/medial maxillectomy, maxillary swing, anterior craniofacial resection, CSF rhinorrhea repair, epistaxis surgery (cautery, sphenopalatine/ anterior ethmoidal/maxillary artery ligation).
• Oral Cavity, Pharynx, Larynx: Adenoidectomy/tonsillectomy, UPPP, oral cavity lesion excision, voice/phonomicrosurgery, tracheostomy, pharyngeal pouch surgery, various tumor resections.
• Neck, Thyroid, Salivary Glands: Lymph node biopsy/neck dissection, thyroidectomy/submandibular/parotid/minor salivary gland surgery, parapharyngeal space tumor surgery, deep neck space infection drainage, tracheostomy.