a LANGE medical book

CURRENT
Diagnosis & Treatment
in Otolaryngology—Head
& Neck Surgery
THIRD EDITION

Edited by
Anil K. Lalwani, MD
Professor
Department of Otolaryngology, Pediatrics, and Physiology & Neuroscience
New York University School of Medicine
New York, New York

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Milan New Delhi San Juan Seoul Singapore Sydney Toronto
Copyright © 2012 by The McGraw-Hill Companies, Inc. All rights reserved. Except as permitted under the United States Copyright Act of
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 Dedication
To my parents, Madan and Gulab, for giving me life;
To my in-laws, Rikhab and Ratan, for adding to my life;
To my wife, Renu, who is my life, And, to my children,
Nikita and Sahil, who show me how to enjoy life.

This book is specially dedicated to all of the extraordinarily gifted and

generous teachers in Otolaryngology—Head and Neck Surgery who provide
inspirational leadership and serve as role models for the next generation.
I would like to express my great appreciation for my own mentors
and their spouses for their incredible impact on our lives: Roger
and Marianna Boles, Robert and Janet Schindler, Robert
and Laurie Jackler, and Noel and Baukje Cohen.

Finally, I am deeply indebted to George and Lori Hall, Susan and Bernie
Mendik, Susan Spencer, and Marica and Jan Vilcek for their support and
commitment to excellence in Otolaryngology.
This page intentionally left blank
 Contents
Authors . .. . . .. . . .. . . ... .. ... ... .. ... ... ... .. ... ... .. .. . . xi III. NOSE 253
Preface . .. . .. . . .. . . .. ... ... ... .. ... ... .. ... ... ... .. ... . . xix
10. Olfactory Dysfunction 253
I. INTRODUCTION 1 Anil K. Lalwani, MD

1. Anatomy 1 11. Congenital Nasal Anomalies 258

Nripendra Dhillon, MBBS, MS Maria V. Suurna, MD

2. Antimicrobial Therapy for Head 12. Nasal Trauma 265

& Neck Infection 42
Jeffrey H. Spiegel, MD, FACS &
Peter V. Chin-Hong, MD & William Numa, MD
Richard A. Jacobs, MD, PhD
13. Nasal Manifestations
3. Radiology 52 of Systemic Disease 273
Nancy J. Fischbein, MD & Amy K. Hsu, MD &
Kenneth C. Ong, MD Ashutosh Kacker, MD, FACS

4. Principles of Radiation Oncology 176 14. Nonallergic & Allergic Rhinitis 282
Ryan J. Burri, MD & Nancy Lee, MD Saurabh B. Shah, MD, FAAOA &
Ivor A. Emanuel, MD, FAAOA
5. Anesthesia 180
Errol Lobo, MD, PhD &
Francesca Pellegrini, MD IV. SINUSES 291

15. Acute & Chronic Sinusitis 291

6. Lasers in Head & Neck Surgery 198
Jeffrey D. Suh, MD &
Bulent Satar, MD & Anil R. Shah, MD, FACS Alexander G. Chiu, MD

16. Frontal Sinus Fractures 302

II. FACE 213
Steven D. Pletcher, MD &
7. Hemangiomas of Infancy Andrew N. Goldberg, MD, MSCE, FACS
& Vascular Malformations 213
17. Paranasal Sinus Neoplasms 309
Joseph L. Edmonds, Jr., MD
Aditi H. Mandpe, MD
8. Maxillofacial Trauma 224
Andrew H. Murr, MD, FACS
V. SALIVARY GLANDS 317
9. Cutaneous Malignant Neoplasms 235 18. Benign Diseases of
C. Patrick Hybarger, MD, FACS the Salivary Glands 317
Fidelia Yuan-Shin Butt, MD

v
 vi CONTENTS

19. Malignant Diseases VIII. LARYNX & HYPOPHARYNX 435

of the Salivary Glands 333
Adriane P. Concus, MD & Theresa N. Tran, MD 29. Clinical Voice Assessment:
The Role & Value of the
Phonatory Function Studies 435
VI. ORAL CAVITY, OROPHARYNX & Krzysztof Izdebski, FK, MA, PhD, CCC-SLP, FASHA
NASOPHARYNX 345
30. Benign Laryngeal Lesions 449
20. Cleft Lip & Palate 345
Michael J. Wareing, MBBS, BSc, FRCS(ORL-HNS),
William Y. Hoffman, MD, FACS, FAAP Richard Millard, MBBS, MA, DLO, &
Seema Yalamanchili, MA
21. Management of
Adenotonsillar Disease 362 31. Malignant Laryngeal Lesions 456
Maria V. Suurna, MD Adriane P. Concus, MD, Theresa N. Tran, MD
Nicholas J. Sanfilippo, MD, &
22. Parapharyngeal Space Neoplasms & Mark D. DeLacure, MD
Deep Neck Space Infections 369
Uchechukwu C. Megwalu, MD & 32. Vocal Cord Paralysis 475
Edward John Shin, MD, FACS Michael J. Wareing, MBBS, BSc, FRCS(ORL-HNS),
Richard Millard, MBBS, MA, DLO, &
23. Benign & Malignant Lesions Juveria Siddiqui, MA
of The Oral Cavity, Oropharynx &
Nasopharynx 377 33. Stridor in Children 481
Nancy Lee, MD, Jonathan Romanyshyn, MD,
Philip D. Yates, MB ChB, FRCS
Nicola Caria, MD, & Jeremy Setton, BA

24. Mandibular Reconstruction 387 34. Laryngeal Trauma 492

Andrew H. Murr, MD, FACS, & Milan R. Amin, MD
Jeffrey H. Spiegel, MD, FACS &
Jaimie DeRosa, MD

25. Jaw Cysts 394 IX. TRACHEA & ESOPHAGUS 501

Richard A. Smith, DDS
35. Congenital Disorders of
the Trachea & Esophagus 501
26. Temporomandibular Disorders 407
Kelly D. Gonzales, MD & Hanmin Lee, MD
Greg Goddard, DDS
36. Benign & Malignant Disorders
of the Esophagus 506
VII. NECK 415
Alexander Langerman, MD
& Marco G. Patti, MD
27. Neck Masses 415
Derrick T. Lin, MD & Daniel G. Deschler, MD 37. Benign & Malignant Disorders
of the Trachea 523
28. Neck Neoplasms & Neck Dissection 426
Michael D. Zervos, MD, Heather Melville, MS,
Aditi H. Mandpe, MD Emmanuel P. Prokopakis, MD, PhD &
Costas Bizekis, MD
 CONTENTS vii

38. Airway Management & Tracheotomy 536 48. Congenital Disorders

of the Middle Ear 661
Kenneth C. Y. Yu, MD
Kevin D. Brown, MD, PhD &
39. Foreign Bodies 543 Samuel H. Selesnick, MD, FACS

Kristina W. Rosbe, MD & Kevin Burke, MD

49. Otitis Media 674

40. Airway Reconstruction 548 Seema Pai, MD, MPH & Sanjay R. Parikh, MD, FACS

Kristina W. Rosbe, MD & Kevin C. Huoh, MD

50. Cholesteatoma 682
41. Sleep Disorders 556 C.Y. Joseph Chang, MD

Kevin C. Welch, MD &

Andrew N. Goldberg, MD, MSCE, FACS 51. Otosclerosis 689
Colin L. W. Driscoll, MD &
Matthew L. Carlson, MD
X. THYROID & PARATHYROID 571

42. Disorders of the Thyroid Gland 571 XIII. INNER EAR 699
Grace A. Lee, MD &
52. Sensorineural Hearing Loss 699
Umesh Masharani, MRCP (UK)
Anil K. Lalwani, MD
43. Parathyroid Disorders 592
53. The Aging Inner Ear 705
Michael C. Singer, MD & David J. Terris, MD, FACS
Anil K. Lalwani, MD

XI. OTOLOGY 599 54. Hereditary Hearing Impairment 713

Nicolas Gürtler, MD
44. Anatomy & Physiology of the Ear 599
John S. Oghalai, MD, & 55. Aural Rehabilitation
William E. Brownell, PhD & Hearing Aids 721
Robert W. Sweetow, PhD, & Troy Cascia, AuD
45. Audiologic Testing 617
Robert W. Sweetow, PhD &
56. Vestibular Disorders 729
Jennifer Henderson Sabes, MS
Jacob Johnson, MD, & Anil K. Lalwani, MD
46. Vestibular Testing 626
Bulent Satar, MD
57. Diving Medicine 739
Allen M. Dekelboum, MD

XII. EXTERNAL & MIDDLE EAR 645 58. Occupational Hearing Loss 747
George A. Gates, MD & William W. Clark, PhD
47. Diseases of the External Ear 645
Kevin D. Brown, MD, PhD,
59. Temporal Bone Trauma 760
Victoria Banuchi, MD, &
Samuel H. Selesnick, MD, FACS John S. Oghalai, MD
 viii CONTENTS

XIV. SKULL BASE 769 XVI. FACIAL NERVE 861

60. Lesions of the Anterior Skull Base 769 69. Anatomy, Physiology, &
Luc G. T. Morris, MD, MS
Testing of the Facial Nerve 861
Lawrence R. Lustig, MD &
John K. Niparko, MD
61. Vestibular Schwannoma
(Acoustic Neuroma) 781
70. Disorders of the Facial Nerve 876
Jacob Johnson, MD & Anil K. Lalwani, MD
Lawrence R. Lustig, MD &
John K. Niparko, MD
62. Nonacoustic Lesions of
the Cerebellopontine Angle 791
Jacob Johnson, MD & Anil K. Lalwani, MD XVII. FACIAL PLASTIC &
RECONSTRUCTIVE SURGERY 899
63. Neurofibromatosis Type 2 800
71. Reanimation of the Paralyzed Face 899
Anil K. Lalwani, MD
Ritvik P. Mehta, MD

64. Osseous Dysplasias 72. Scar Revision 906

of the Temporal Bone 805
Nathan Monhian, MD, FACS &
Betty S. Tsai, MD & Steven W. Cheung, MD Anil R. Shah, MD, FACS

65. Neoplasms of the 73. The Aging Face: Rhytidectomy,

Temporal Bone & Skull Base 810 Browlift, Midface Lift 912
John S. Oghalai, MD Richard Zoumalan, MD, Douglas
Leventhal, MD, & W. Matthew White, MD
66. Neurotologic Skull Base Surgery 829
74. Blepharoplasty 922
Robert K. Jackler, MD
Eugene J. Kim, MD &
Corey S. Maas, MD

XV. MIDDLE EAR & 75. Rhinoplasty 928

COCHLEAR IMPLANTS 845
Douglas D. Leventhal, MD &
67. Implantable Middle Minas Constantinides, MD, FACS
Ear Hearing Devices 845
Betty S. Tsai, MD & Steven W. Cheung, MD 76. Hair Transplantation 939
Marc R. Avram, MD &
Nicole E. Rogers, MD
68. Cochlear Implants 850
Michael B. Gluth, MD, 77. Local Skin Flaps in
Colin L.W. Driscoll, MD, & Facial Reconstruction 945
Anil K. Lalwani, MD
Judy Lee, MD, & W. Matthew White, MD
 CONTENTS ix

78. Microvascular Reconstruction 950 80. Facial Fillers & Implants 975
Vasu Divi, MD & Anil R. Shah, MD, FACS,
Daniel G. Deschler, MD, FACS Jeffrey B. Wise, MD, &
Minas Constantinides, MD, FACS
79. Otoplasty & Microtia 960
Jeffrey B. Wise, MD, Index ...... ...... ...... ...... ....... ...... ...... .... .. 979
Sarmela Sunder, MD,
Vito Quatela, MD &
Minas Constantinides, MD, FACS
This page intentionally left blank
 Authors
Milan R. Amin, MD Kevin Burke, MD
Assistant Professor Resident in Otolaryngology
Department of Otolaryngology Department of Otolaryngology-Head and Neck Surgery
New York University School of Medicine University of California
New York, New York San Francisco, California
Laryngeal Trauma Foreign Bodies

Marc R. Avram, MD Ryan J. Burri, MD

Clinical Associate Professor Instructor in Clinical
Department of Dermatology Department of Radiation Oncology
Weill Cornell Medical Center Columbia University College of Physicians and Surgeons
New York, New York New York, New York
Hair Transplantation Principles of Radiation Oncology

Victoria Banuchi, MD, MPH Fidelia Yuan-Shin Butt, MD

Resident Adjunct Clinical Assistant Professor
Department of Otolaryngology Department of Otolaryngology/Head
New York Presbyterian Hospital and Neck Surgery
New York, New York Stanford University
Diseases of the External Ear Stanford, California
Benign Diseases of the Salivary Glands
Costas S. Bizekis, MD
Assistant Professor of Cardiothoracic Surgery Nicola Caria, MD
Division of Thoracic Surgery, Department of Varian Oncology Systems
Cardiothoracic Surgery San Francisco, California
New York University Langone Medical Center Benign & Malignant Lesions of The Oral Cavity,
New York, New York Oropharynx & Nasopharynx
Benign & Malignant Disorders of the Trachea
Matthew L. Carlson, MD
Kevin D. Brown, MD, PhD Senior Resident
Assistant Professor Department of Otolaryngology
Department of Otorhinolaryngology The Mayo Clinic
Weill Cornell Medical College Rochester, Minnesota
New York, New York Otosclerosis
Diseases of the External Ear; Congenital
Disorders of the Middle Ear Troy Cascia, AuD
Clinical Audiologist
William E. Brownell, PhD Audiology Clinic
Professor and Jake and Nina Kamin Chair of University of California
Otorhinolaryngology San Francisco Medical Center
Bobby R. Alford Department of Otolaryngology- San Francisco, California
Head & Neck Surgery Aural Rehabilitation & Hearing Aids
Baylor College of Medicine
Houston, Texas C.Y. Joseph Chang, MD
Anatomy & Physiology of the Ear Clinical Professor
Department of Otorhinolaryngology-
Head and Neck Surgery
University of Texas-Houston Medical School
Houston, Texas
Cholesteatoma

xi
 xii AUTHORS

Steven W. Cheung, MD Allen M. Dekelboum, MD

Associate Professor Clinical Professor, Retired
Otolaryngology-Head and Neck Surgery Otolaryngology-Head & Neck Surgery
University of California-San Francisco University of California-San Francisco
San Francisco, California California
Osseus Dysplasias of the Temporal Bone; Instructor Trainer, Emeritus, National Association
Implantable Middle Ear Hearing Devices of Underwater Instructors, Tampa, Florida;
Instructor Trainer, Divers Alert Network,
Peter V. Chin-Hong, MD Durham, North Carolina.
Assistant Professor of Medicine Diving Medicine
University of California-San Francisco
San Francisco, California Mark D. DeLacure, MD
Antimicrobial Therapy for Head & Neck Infection Chief, Division of Head and Neck Surgery and Oncology
Department of Otolaryngology—Head and Neck Surgery
Alexander G. Chiu, MD Associate Professor of Plastic Surgery
Associate Professor, Director of Rhinology Institute of Reconstructive Plastic Surgery
and Skull Base Surgery Fellowship Program Department of Surgery
Department of Otorhinolaryngology NYU Clinical Cancer Center
University of Pennsylvania NYU School of Medicine
Philadelphia, Pennsylvania New York, New York
Acute & Chronic Sinusitis Malignant Laryngeal Lesions

William W. Clark, PhD Jaimie DeRosa, MD

Director, Program in Audiology and Department of Otolaryngology
Communication Sciences Geisner Medical Center
Professor, Department of Otolaryngology Danville, Pennsylvania
Professor, Program in Audiology and Mandibular Reconstruction
Communication Sciences (Joint)
Professor, Department of Education (Joint) Daniel G. Deschler, MD, FACS
Washington University School of Medicine Associate Professor
St. Louis, Missouri Department of Otology and Laryngology
Occupational Hearing Loss Harvard Medical School, Massachusetts Eye and Ear
Infirmary
Adriane P. Concus, MD Boston, Massachusetts
Participant Physician Neck Masses; Microvascular Reconstruction
The Permanente Medical Group, Inc.
Department of Head and Neck Surgery, Kaiser Nripendra Dhillon, MBBS, MS
South San Francisco Lecturer in Anatomy
South San Francisco, California Department of Anatomy
Malignant Diseases of the Salivary Glands; Malignant University of California-San Francisco
Laryngeal Lesions San Francisco, California
Anatomy
Minas Constantinides, MD, FACS
Assistant Professor and Director of Facial Plastic & Vasu Divi, MD
Reconstructive Surgery Fellow in Head and Neck Oncology, Skull Base,
Department of Otolaryngology and Microvascular Reconstructive Surgery
New York University Langone Medical Center Massachusetts Eye and Ear Infirmary
New York, New York Harvard Medical School
Rhinoplasty Boston, Massachusetts
Microvascular Reconstruction
 AUTHORS xiii

Colin L.W. Driscoll, MD Andrew N. Goldberg, MD, MSCE, FACS

Associate Professor Professor
Department of Otorhinolaryngology Otolaryngology-Head and Neck Surgery
Head and Neck Surgery University of California-San Francisco
Mayo Clinic San Francisco, California
Rochester, Minnesota Sleep Disorders; Frontal Sinus Fractures
Otosclerosis; Cochlear Implants
Kelly D. Gonzales, MD
Joseph L. Edmonds Jr, MD Postdoctoral Research Fellow
Cinical Assistant Professor Department of Surgery
Department of Otolaryngolgogy and Plastic Surgery University of California-San Francisco
Baylor College of Medicine and Weill Cornell Medical San Francisco, California
College, University of Texas Congenital Disorders of the Trachea & Esophagus
Houston, Texas
Hemangiomas of Infancy & Vascular Malformations Nicolas Gürtler, MD
Privatdozent (Associate Professor)
Ivor A. Emanuel, MD, FAAOA Department of Otolaryngology
Clinical Assistant Professor, Cantonal Hospital
Department of Otolaryngology Aarau
University of California-San Francisco Switzerland
San Francisco, California Hereditary Hearing Impairment
Nonallergic & Allergic Rhinitis
William Y. Hoffman, MD, FACS, FAAP
Nancy J. Fischbein, MD Professor and Chief
Associate Professor Division of Plastic and Reconstructive Surgery
Department of Radiology, University of California-San Francisco
Otolaryngology-Head and Neck Surgery, San Francisco, California
Neurology, and Neurological Surgery Cleft Lip & Palate
Stanford University
Stanford, California Amy K. Hsu, MD
Radiology Department of Otorhinolaryngology
Weill Cornell Medical College
George A. Gates, MD New York, New York
Emeritus Professor Nasal Manifestations of Systemic Disease
Department of Otolaryngology-Head and Neck Surgery
University of Washington Kevin C. Huoh, MD
Seattle, Washington Chief Resident
Occupational Hearing Loss Otolaryngology- Head and Neck Surgery
University of California-San Francisco
Michael B. Gluth, MD San Francisco, California
Assistant Professor Airway Reconstruction
Department of Otolaryngology-
Head & Neck Surgery C. Patrick Hybarger, MD, FACS
University of Arkansas for Medical Sciences Assistant Clinical Professor
Little Rock, Arkansas Otolaryngology/Head and Neck Surgery
Cochlear Implants University of California-San Francisco
San Francisco, California
Greg Goddard, DDS Cutaneous Malignant Neoplasms
Department Oral and Maxillofacial Surgery
University of California-San Francisco
Center for Orofacial Pain
San Francisco, California
Temporomandibular Disorders