Head and neck surgery is now a well-established and recognized subspecialty of otolaryngology. Although otolaryngologist-head and neck surgeons provide care to patients with a wide variety of diseases of the head and neck region, the focus of this subspecialty is on the management of neoplasms, both benign and malignant.

The anatomic and physiologic complexity of the head and neck makes it one of the most challenging and exciting regions of the body. All five senses function in this region, with four of them (vision, hearing and balance, taste, and smell) limited to the head and neck region only. In addition, crucial functions such as breathing, swallowing, coughing, and speaking depend on intact anatomy and physiology of the head and neck. Moreover, function and appearance of head and neck structures play an important role in every person’s self-image, nonverbal communication, profession, and self-esteem. These factors are important for the head and neck surgeon to consider when faced with a patient with a challenging tumor. Survival is no longer accepted as the only measurement of treatment success. Making every attempt to cure the disease with emphasis on preservation and/or reconstruction of senses, functions, and appearance, guide the modern head and neck surgeon and the head and neck multidisciplinary team in therapeutic considerations.

The last two decades of the 20th century provided us with major advances in related disciplines, which improved our diagnostic and therapeutic considerations and patient outcome. Most of these advances are covered in other chapters in this book. Modern imaging studies such as high-resolution MR and CT scanning, PET scanning, fusion of two scanning modalities, and “superprecise” interventional radiology, to name a few, give the treating physician a better mapping of the lesions, detect metastasis earlier, and provide reliable methods of follow-up and early identification of recurrent disease. Advances in radiation oncology equipment and techniques provide us with a more accurate radiation treatment protocols and less damage to surrounding normal tissues. Advances in pharmacology provide us not only with more potent and less toxic chemotherapeutics agents, but also with new medications that protect the patient from the side effects of radiation therapy and other chemotherapy drugs. Endoscopic instrumentation and techniques, combined with sophisticated intraoperative computerized navigation technology, provide the head and neck surgeon with minimally invasive extirpation techniques, especially in the larynx and paranasal sinuses. The results are better preservation of normal tissues and improved functional outcome, without compromising sound oncologic resection. And last but not least, the reconstructive head and neck surgeon plays a crucial role in the overall management
of the patient with a head and neck neoplasm. Modern reconstructive techniques provide us with replacement of major structures and help us to preserve function and appearance.