Preface

I am very pleased to have had the opportunity to be the Guest Editor for this issue of Seminars in Pediatric Surgery on “Head and Neck Surgery in Children.” This is a topic of great interest to pediatric surgeons and other pediatric surgical specialists as they see many children with significant acquired diseases and congenital disorders affecting the head and neck region. For this reason, I am hopeful that the readers will find this issue of Seminars in Pediatric Surgery of particular value. We have selected senior authors because of their widely known expertise in managing these disorders. I am extremely grateful to each of them for their willingness to contribute to this collective work.

In this issue, we have covered many of the traditional and important subject areas of congenital head and neck lesions and neoplastic disorders, as well as infection and inflammation. Dr. John Waldhausen succinctly discusses the patho-embryology of branchial cleft and arch anomalies and the treatment of the spectrum of these common anomalies. Drs. David Foley and Mary Fallat describe the evaluation and treatment of thyroglossal duct anomalies and other midline cervical lesions. Drs. Mehta and Willging share their expertise in the management of both common and rare salivary gland lesions, including neoplastic and inflammatory diseases. Thyroid and parathyroid diseases in children are less common but are associated with significant morbidity if unrecognized. Drs. Stafford and Skinner provide a comprehensive view of the evaluation and management of a variety of thyroid and parathyroid disorders. They address the controversies in treatment approaches to thyroid carcinoma and provide a brief but clear summary of the recent advances in our understanding of the genetics of multiple endocrine neoplasia. Drs. Dickson and Davidoff provide an excellent overview of head and neck malignant neoplasms with an emphasis on diagnosis, staging, and the role of surgery in the treatment of these tumors. Cervical lymphadenitis is one of the most common problems seen in childhood. Drs. John Goshe and Laura Vick discuss the different etiologies, presentation, and management of acute, subacute, and chronic cervical lymphadenitis in children.

In addition, we have selected several new topics, including contributions related to cervicofacial vascular anomalies and to both prenatal and postnatal upper airway obstruction. Fetal diagnosis of major cervicofacial anomalies is now common; however, the management of a fetus with a complex mass lesion potentially obstructing the airway remains a significant clinical challenge. Drs. Marwan and Crombleholme provide a comprehensive state of the art review of the role and steps in performing an EXIT procedure to manage the high-risk fetus during the delivery process. Dr. Michael Rutter in his paper emphasizes both common and rare causes of upper airway obstruction in children. The spectrum of anomalies he discusses includes choanal atresia to complex laryngeotracheal clefts and congenital tracheal stenosis from complete cartilaginous rings. Finally, Drs. Adams, Lucky, Elluru, and Azizkhan discuss the classification, diagnosis, and management of vascular anomalies in children. The International Society for the Study of Vascular Anomalies has developed a consensus binary classification system of vascular tumors and vascular malformations. This important subject is presented in sequential papers because of the scope of the subject material and the currently accepted classification system.

These latter four papers underscore the importance and value of organized interdisciplinary teams for evaluating and treating a fetus or children with complex malformations, major airway anomalies, and vascular anomalies. It is my belief that pediatric surgeons need to play a crucial leadership role in creating and sustaining these interdisciplinary teams.