Pediatric Head and Neck Masses: Avoiding Pitfalls and Optimizing Outcomes

PROGRAM DESCRIPTION: Few things worry parents and referring clinicians as much as head and neck masses in children making this a relatively common complaint for both the general and pediatric otolaryngologist alike. These are often benign congenital lesions, infections, or reactive lymphadenopathy. But, as discussion of such masses is a routine part of the otolaryngology residency and pediatric fellowship, as they carry a small but devastating risk of malignancy, and as their complications bring significant cosmetic and functional consequences, there is little room for error in the diagnostic and therapeutic management of these children. From thyroglossal duct and branchial cleft cysts to chronic granulomatous lymphadenitis, from lymphoproliferative disorders to frank lymphoma, from thyroid to salivary neoplasms and many more, there are complex decisions in the clinical management of pediatric head and neck masses regarding imaging and tissue sampling protocols, timing of surgery versus age, malignancy risk, or anesthetic concerns, and counseling through observation periods. Once in the operating room, there are subtle nuances in our understanding of anatomy and approach that can prevent dreaded complications such as fistula, recurrence, airway compromise, and neurovascular injury. In this session, the codirectors of two large pediatric head and neck tumor programs will discuss some of the common pediatric head and neck masses that form a component of many general and specialist practices with the aims to optimize evidence-based approaches to care, to review tips for safe and successful surgery, and to empower providers to most effectively counsel very nervous parents and primary care providers. The panelists will review available literature and share from their surgical experiences. Aspects of this presentation will address basic concepts appropriate for medical students and residents intermixed with more advanced concepts for practicing surgeons.