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SELF-ASSESSMENT IN HEAD AND NECK SURGERY AND ONCOLOGY This page intentionally left blank SELF-ASSESSMENT IN HEAD AND NECK SURGERY AND ONCOLOGY EDITORS: James Paul O’Neill, MD, MB, FRCSI, MMSc, MBA, ORL-HNS Professor of Otolaryngology, Head and Neck Surgery The Royal College of Surgeons in Ireland St. Stephen’s Green Dublin, Ireland; Consultant Otolaryngology Head and Neck Surgeon Beaumont Hospital Dublin, Ireland Jatin P. Shah, MD, PhD (Hon), FACS, FRCS (Hon), FDSRCS (Hon), FRACS (Hon) Chief, Head and Neck Service E.W. Strong Chair in Head and Neck Oncology Memorial Sloan Kettering Cancer Center; Professor of Surgery Weill Cornell Medical College of Cornell University New York, New York United States ASSOCIATE EDITORS: Ian Ganly, MD, PhD, FRCS Luc G. T. Morris, MD, MSc Snehal Patel, MD, MS, FRCS Ashok Shaha, MD, FACS Bhuvanesh Singh, MD, PhD, FACS 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 SELF-ASSESSMENT IN HEAD AND NECK SURGERY AND ONCOLOGY ISBN: 978-0-323-26003-9 Copyright © 2015 by Saunders, an imprint of Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and e xperience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in e valuating and using any information, methods, compounds, or experiments described herein. In using such in- formation or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, i nstructions, or ideas contained in the material herein. Library of Congress Cataloging-in-Publication Data Self-assessment in head and neck surgery and oncology / editors, James Paul O’Neill, Jatin P. Shah ; associate editors, Ian Ganly, Luc G.T. Morris, Snehal Patel, Ashok Shaha, Bhuvanesh Singh. p.; cm. Proudly sourced and uploaded by [StormRG] Includes bibliographical references and index. Kickass Torrents | TPB | ET | h33t ISBN 978-0-323-26003-9 (pbk. : alk. paper) I. O’Neill, James Paul, editor of compilation. II. Shah, Jatin P., editor of compilation. III. Ganly, Ian, editor of compilation. [DNLM: 1. Head and Neck Neoplasms--surgery--Examination Questions. 2. Head--surgery-- Examination Questions. 3. Neck--surgery--Examination Questions. WE 18.2] RC280.H4 616.99’4910076--dc23 2014004737 Senior Content Strategist: Belinda Kuhn Senior Content Development Manager: Maureen Iannuzzi Publishing Services Manager: Patricia Tannian Senior Project Manager: Kristine Feeherty Design Direction: Ellen Zanolle Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 To our families, for their love and support To our patients, for their bravery enduring the burden of head and neck disease Preface The term “cancer of the head and neck” generally includes neoplasms arising from the mucosa of the upper aerodigestive tract, including the nasal cavity and paranasal sinuses, as well as tumors of the salivary glands, thyroid and parathyroid glands, and neoplasms arising from the skin, soft tissues, and bones of the craniofacial skeleton. Tumors of neurovascular origin and those arising in the ear canal, temporal bone, orbit, and skull base are also included in this list. Over the course of the past century, the specialty treating these tumors has evolved into a very complex multidisciplinary field requiring the expertise of head and neck surgeons, radiation oncologists, medical oncologists, maxillofacial/dental surgeons, reconstructive microsurgeons, and other allied specialists. The training programs for specializing in this complex specialty have also evolved over the course of the past 30 years, with the need to incorporate training in increasingly complex technologies, development of new skill sets, and integration of exposure to nonsurgical disciplines. An increasing number of textbooks have been published over the past 20 years, as well as a plethora of published journal articles, with emphasis on multidisciplinary treatments. Ample literature is available for the trainee and the practitioner to remain abreast of the advances made in the field. However, no specialty or board certification examination is available in this complex field, and thus there is no measure of one’s competency in the specialty. The graduates of the senior fellowship program in head and neck surgery and oncology and the faculty of the head and neck program at Memorial Sloan Kettering Cancer Center in New York have created this self-assessment compendium to measure the fundamental basic knowledge required of an individual engaged in the specialty of head and neck surgery and oncology. This book by no means is sufficient to measure competency in the specialty, nor is it intended to be sufficient to gain certification in the specialty. On the other hand, it certainly introduces the reader to the process of self-assessment of knowledge, judgment, an algorithmic thinking process, and the decision-making ability in dealing with day-to-day problems in patients with neoplasms aris- ing in the head and neck. Each chapter contains a topic, following the sequence of the chapters in Jatin Shah’s Head and Neck Surgery and Oncology, Fourth Edition. The questions are presented in three categories: (1) True or False, (2) Single Best Answer, and (3) Multiple Choice combinations. Each chapter includes the basic Core Knowledge required and has a Suggested Reading list. The answers to the questions are provided at the end of each chapter. It is our hope that the reader will benefit from initially taking the examination, pursue the topic further by reviewing the Core Knowl- edge, and then gain further knowledge from reading the recommended textbooks. We also hope that this initial attempt at self-assessment will stimulate the reader to remain engaged in continuing medical education in order to remain current with this rapidly advancing specialty. Acknowledgment We would like to express our sincere appreciation and special thanks to the faculty of the head and neck service of Memorial Sloan Kettering Cancer Center for their advice, input, guidance, and support throughout this project. Our special thanks are also due to the editorial staff of the head and neck service who provided timely help in processing the manuscripts and numerous edits and corrections to bring about this work. Finally, we want to thank each and every one of the contributors to this book, the faculty members of the head and neck service, former fellows of the head and neck program, and the current fellows on the service for their hard and ingenious work in developing the ques- tions, which truly test the knowledge of the reader. We are grateful for their support. James Paul O’Neill, MD, MB, FRCSI, MMSc, MBA, ORL-HNS Jatin P. Shah, MD, PhD (Hon), FACS, FRCS (Hon), FDSRCS (Hon), FRACS (Hon) vi Contributors George C. Bohle III, DDS Ian Ganly, MD, PhD, FRCS Clinical Assistant Professor Associate Professor of Otolaryngology and University of Oklahoma College of Head and Neck Surgery Dentistry; Weill Cornell Medical College of Cornell Private Practice University; Implant and Prosthodontic Associates Associate Attending Surgeon Oklahoma City, Oklahoma Memorial Sloan Kettering Cancer Center United States New York, New York Oncological Dentistry: Maxillofacial Pros- United States thetics and Implants Lips and Oral Cavity Jeffrey Chang-Jen Liu, MD Babak Givi, MD Assistant Professor of Otolaryngology and Assistant Professor of Otolaryngology, Head and Neck Surgery Head and Neck Surgery Temple University School of Medicine; New York University School of Medicine Assistant Professor of Head and Neck Surgery NYU Langone Medical Center Fox Chase Cancer Center New York, New York Philadelphia, Pennsylvania United States United States Reconstructive Surgery Larynx and Trachea Allen S. Ho, MD Natalya Chernichenko, MD Assistant Professor of Surgery Assistant Professor of Otolaryngology Cedars-Sinai Medical Center Chief of Head and Neck Surgery Los Angeles, California SUNY Downstate Medical Center United States Brooklyn, New York Nutrition United States Neurogenic Tumors and Paragangliomas Nora Katabi, MD Assistant Attending Mark D. DeLacure, MD, FACS Department of Pathology Chief, Division of Head and Neck Surgery Memorial Sloan Kettering Cancer Center and Oncology New York, New York Department of Otolaryngology, Head and United States Neck Surgery Pathology Associate Professor of Plastic Surgery Institute of Reconstructive Plastic Surgery Nancy Lee, MD Department of Plastic Surgery Attending New York University School of Medicine Department of Radiation Oncology New York University Clinical Cancer Center Memorial Sloan Kettering Cancer Center New York, New York New York, New York United States United States Reconstructive Surgery Radiation Oncology Matthew Fury, MD, PhD Ellie Maghami, MD, FACS Assistant Member Associate Professor Memorial Sloan Kettering Cancer Center; Chief, Division of Otolaryngology and Assistant Attending Physician Head and Neck Surgery Memorial Hospital City of Hope National Medical Center New York, New York Duarte, California United States United States Chemotherapy Nasal Cavity and Paranasal Sinuses vii viii CONTRIBUTORS Arash Mohebati, MD Rahmatullah Rahmati, MD Attending Surgeon Assistant Professor of Otolaryngology, John Muir Medical Center Head and Neck Surgery Walnut Creek, California Columbia University Medical Center United States New York, New York Pharynx and Esophagus United States Bone Tumors and Odontogenic Tumors Luc G.T. Morris, MD, MSc Assistant Professor of Otolaryngology Nadeem Riaz, MD Weill Cornell Medical College of Cornell Resident Physician University; Department of Radiation Oncology Assistant Attending Surgeon Memorial Sloan Kettering Cancer Center Memorial Sloan Kettering Cancer Center New York, New York New York, New York United States United States Radiation Oncology Skin Patrick Sheahan, MD, MB, FRCSI Iain James Nixon, PhD (ORL-HNS) Consultant Ear, Nose, and Throat/Head and Clinical Lecturer Neck Surgeon University College Cork; East Kent Hospitals University NHS Consultant Otolaryngologist, Head and Foundation Trust Neck Surgeon Ashford, Kent South Infirmary Victoria University Hospital United Kingdom Cork, Ireland Thyroid and Parathyroid Cervical Lymph Nodes Caitriona O’Neill, PhD, BSc(Pharm), Andrew G. Shuman, MD MBA, Dip Stat Department of Otolaryngology, Head and Trinity College Dublin Surgery Dublin, Ireland University of Michigan Health System Epidemiology and Biostatistics Ann Arbor, Michigan United States James Paul O’Neill, MD, MB, FRCSI, Eyelids and Orbit MMSc, MBA, ORL-HNS Professor of Otolaryngology, Head and Hilda Stambuk, MD Neck Surgery Attending Radiologist The Royal College of Surgeons in Ireland Clinical Head of Head and Neck Imaging St. Stephen’s Green Department of Radiology Dublin, Ireland; Memorial Sloan Kettering Cancer Center Consultant Otolaryngology Head and New York, New York Neck Surgeon United States Beaumont Hospital Radiology Dublin, Ireland Skull Base; Pharynx and Esophagus; Salivary Volkert Wreesmann, MD, PhD Glands; Soft Tissue Tumors; Surgical Anatomy Head and Neck Surgeon Department of Otolaryngology, Head and Daniel Louis Price, MD Neck Surgery Assistant Professor Netherlands Cancer Institute Department of Otolaryngology, Head and University Medical Center Utrecht Neck Surgery Amsterdam and Utrecht Mayo Clinic The Netherlands Rochester, Minnesota Molecular Oncology United States Salivary Glands

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