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Treatment Treatment must include excision of the whole thyroglossal tract, which involves removal of the body of the hyoid bone and the suprahyoid tract through the tongue base to the vallecula at the site of the primitive foramen caecum, together with a c...

Tuberculous adenitis This condition most commonly a ff ects children or young adults but can occur at any age. The deep upper cervical nodes are most commonly a ff ected, but there may be a widespread cervical lymphadenitis with matted nodes. In most cases, the ...

Tumours of the larynx Benign tumours of the larynx are extremely rare. Squamous cell carcinoma is the most common malignant tumour, being responsible for more than 90% of tumours within the larynx. It is the second most common head and neck cancer (oral cavi...

Tumours of the nasopharynx Benign There are two main types of benign tumours of the nasophar ynx: the angiofibroma and the antrochoanal polyp. Both are rare. Angiofibroma This tumour is confined to young male patients most commonly between the ages of 8 and 20...

Tumours of the oropharynx mal Benign Benign tumours of the oropharynx are rare, papillomas being the most common. These are usually incidental findings and are rarely of any importance. Figure 52.35 Squamous cell carcinoma of the right tonsil. Figure 52.36 Sq...

VOICE DISORDERS Vocal nodules These are fibrous thickenings of the vocal folds at the junction - of the middle and anterior thirds ( Figure 52.52 ) and result from vocal abuse; they are known as singers’ nodules in adults and screamers’ nodules in children. S...

Vagal body tumours Vagal paragangliomas arise from nests of paraganglionic tissue of the vagus nerve just below the base of the skull near the jugular foramen. They may also be found at various sites along the nerve down to the level of the carotid artery bi...

Vocal fold palsy This may be unilateral or bilateral ( Figure 52.55 ). Unilateral cord palsy is most commonly idiopathic. In non-idiopathic cases, left vocal fold palsy is most common because of the long intrathoracic course of the left recurrent laryngeal ne...

Vocal fold polyps These are usually unilateral and may be associated with an acute infective episode, cigarette smoking or vocal abuse ( Figure 52.53 ). Speech therapy is again indicated, but they do usually require removal by microdissection or laser surgery ...

Voice rehabilitation The loss of the larynx as a generator of sound does not prevent patients speaking as long as an alternative source of sound can be created by vibration in the pharynx. This can be achieved - in one of three ways: 1 A small one-way valv...

Wounds above the hyoid bone The cavity of the mouth or pharynx may have been entered and the epiglottis may be transected. These wounds require repair with absorbable sutures under a general anaesthetic. If there is any degree of associated oedema or bleedin...

Wounds of the thyroid and cricoid cartilage Blunt crushing injuries or severe laceration injuries to the laryngeal skeleton can cause marked haematoma formation or swelling and rapid loss of the airway . There may be significant disruption of the laryngeal ske...

ACKNOWLEDGEMENTS The authors acknowledge Professor RJ Shaw , Professor JS Brown and Professor C Butterworth for clinical photographs utilised in this chapter. ACKNOWLEDGEMENTS The authors acknowledge Professor RJ Shaw , Professor JS Brown and Professor C Butte...

ADJUVANT THERAPY FOR THE MANAGEMENT OF ORAL CA VITY CANCER While primary chemoradiotherapy can be o ff ered to patients who are unsuitable for or refuse surgery , primary surgery , ). with/without adjuvant (chemo)radiotherapy , is the standard (b) (b) The resec...

ADJUVANT THERAPY FOR THE MANAGEMENT OF ORAL CA VITY CANCER While primary chemoradiotherapy can be o ff ered to patients who are unsuitable for or refuse surgery , primary surgery , ). with/without adjuvant (chemo)radiotherapy , is the standard (b) (b) The resec...

Adjuvant chemoradiotherapy The landmark RTOG 9501 and EORTC 22931 randomised - trials form the basis for the contemporary role of adjuvant chemotherapy (CRT) in high-risk OCSCC (although only 25% benefit conferred by adding high-dose cisplatin to conventional ...

Biopsy Primary tumour Histopathological diagnosis via a formal biopsy is the gold standard prior to further investigation and treatment. An incisional biopsy is preferred. It is important to avoid necrotic areas, and a narrow deep biopsy is more useful than a ...

Bone invasion Three patterns of bone invasion, namely infiltrative, erosive or mixed, have been described. There is strong evidence that most tumours enter the bone at the point of contact in an erosive fashion, and not via foramina or the periodontal membran...