Head & Neck / Thyroid

Common Conditions

Head/neck cancer – There are many types of cancer that can involve structures of the head or neck.  The most common type of head and neck cancer is squamous (pronounced skway-mus) cell cancer, which can arise from the surfaces of the nose, mouth and throat.  Common risk factors for this type of cancer are smoking and alcohol consumption, but other factors like genetics and exposure to certain viruses also can impact a person’s chance of developing squamous cell cancer.  Common symptoms/signs associated with head and neck cancer include: painless lumps in the neck (in adults), swallowing problems, voice changes, coughing up blood, and unexplained weight loss.

Thyroid disease – The thyroid gland is a butterfly-shaped organ that sits low in the front the neck.  Its main function is to produce thyroid hormone, which helps control the metabolism of cells in the body.  Thyroid disease is very common, and can include alteration in the hormone production of the thyroid gland (ie. too much or too little hormone production), an enlarged thyroid gland (goiter), nodules (lumps within the gland), or thyroid cancer.  Evaluation of the thyroid gland usually involves physical examination by your doctor, bloodwork to assess the function of the gland, and sometimes an ultrasound to examine the structure of the gland.  For more information about thyroid disease, consult the American Thyroid Association (www.thyroid.org) or American Academy of Otolaryngology – Head & Neck Surgery (www.entnet.org ).

Parathyroid disease – The parathyroid glands are small, pea-sized glands that reside next to the thyroid gland low in the neck.  Most people have four parathyroid glands.  They secrete a hormone (parathyroid hormone) which helps regulate calcium levels in the body.  Abnormalities of these glands can result in a variety of problems including kidney stones and osteoporosis.  Sometimes surgery is needed to remove one or more abnormal parathyroid glands.

Salivary gland disease – There are three sets of major salivary glands: the parotid glands (in front of the ears within the cheeks), the submandibular glands (walnut-sized glands under the jawline in the chin area) and the sublingual glands (under the lining of the mouth beneath the tongue).  The lining of the mouth also contains hundreds of small, minor salivary glands beneath the surface.  Problems that can occur in the salivary glands include: infections, tumors, and “stones” (similar to kidney stones) which can block the flow of saliva into the mouth.

Common Surgical Procedures

Thyroidectomy – Removal of all or part of the thyroid gland may be performed for a number of reasons, including: the presence of a nodule (mass), thyroid cancer, or enlargement of the gland. Thyroid surgery is performed under general anesthesia in the operating room, and patients usually spend the night in the hospital.

Parathyroidectomy – The most common reason for removal of a parathyroid gland is the overproduction of parathyroid hormone, which is often due to a single, overly-active gland called an adenoma.  Surgery is performed under general anesthesia in the operating room, and patients stay in the hospital overnight in order to closely monitor blood calcium levels after the procedure.

Salivary gland excision

  • Parotidectomy – Common reasons to remove all or part of the parotid gland include the presence of tumors or chronic inflammation of the gland.  Parotid surgery is performed under general anesthesia.  The nerve that controls most of the facial movement on each side (facial nerve) exits the skull and branches within the substance of the parotid gland.  Surgery of the parotid gland, therefore, involves careful identification of the facial nerve and its branches in order to keep them safe.  Often a special device called a nerve monitor is used to help provide an additional measure of safety.
  • Submandibular gland excision – The roughly walnut-sized submandibular glands sit below the jawline in the chin area.  There is one gland on either side of the chin/neck.  Common reasons to remove one or both of these glands include chronic inflammation, tumors within the gland, or the presence of stones within the ducts that drain the saliva from the glands (similar to kidney stones).  The surgery is performed under a general anesthesia, and involves an incision below the jawline on the side of the neck.