Facial Plastic Surgery – Head, Neck, Facial Cancer Notes


Triangles of the neck – anatomy

Most of this is probably of interest to folks that work with facial anatomy: such as ENT’s – Ear Nose Throat surgeons, facial plastic surgeons, cosmetic surgeons, and those who work around the face all the time such as dermatologists, and cosmetic injectors who perform Botox and dermal fillers.  These are notes that I took for myself while reviewing some head and neck cancer issues.  Keeping up to date and reviewing medical knowledge is important for my – Calvin Lee, MD – surgical practice in Modesto, CA.

Sistrunk Procedure for Thyroid Glossal Duct Cysts with papillary carcinoma

Surgical Review: Sistrunk Procedure (of which I’ve done a few in my career) and some with assistance from my expert Modesto surgeon friend Dr. Suntra (ENT/facial plastic surgeon) is used for the removal of thyroid glossal duct cysts and involves the cyst removal in continuity with the tract, central portion of the hyoid bone, and tissue above the hyoid bone to the base of the tongue. This procedure is usually considered adequate for a finding of a well differentiated papillary carcinoma of the thyroid.

Fine Needle Aspiration for diagnosing neck lymph nodes

Surgical Review: FNA (fine needle aspiration) is considered first line for tissue diagnosis for a solitary neck mass suspicious for metastatic squamous cell carcinoma.

Tonsils – the great sequester of cancer in the head and neck

Surgical Review: Consider tonsils when finding a non-obvious source of metastatic squamous cell carcinoma in the upper neck.

Metachronous and Synchronous – definition

Surgical Review head and neck cancers: Metachronous means occurring at different times, as opposed to synchronous (at the same time).

Lateral Aberrant Thyroid = papillary thyroid carcinoma

My personal Surgical Review: Lateral Aberrant Thyroid is a lymph node metastasis from papillary thyroid carcinoma. Consider the surgery of: total thyroidectomy with a neck dissection ie. central compartment.


Wartin’s Tumor – treat with parotidectomy superficial or total

My personal Surgery Review: Papillary Cystadenoma Lymphomatosum (Warthin’s Tumor) is a benign salivary tumor (like pleomorphic adenoma), which is usually in the Partoid gland. Treatment is excision with superficial (lateral) parotidectomy or total parotidectomy (which preserves the facial nerve) depending on location of the benign tumor. Enucleation is contraindicated due to recurrence.


Facial nerve, parotid gland



Just some personal notes for Calvin Lee, MD Modesto, CA.  No medical advice here.