Amy Y. Chen, MD, MPH, FACS

This paper by Drs. Bhayani, Holsinger, and Lai describes a new approach to an old problem. Advances in the management of head and neck cancer over the past few decades have been made predominantly in the area of non-surgical therapy. Starting with the Veterans Affairs Cooperative Trial for laryngeal cancer in the early 1990’s,[1] advances in the administration of chemotherapy and radiation therapy have enabled patients to forego traditional extensive resections that compromised speech and swallowing function.[2] The advances in combined chemoradiation for advanced head and neck cancer have come with a detriment to some patients in survival and quality of life.[3] Effective treatment, but with decreased morbidity was needed.

Paragangliomas are unusual tumorsof the head and neck butshould be included in the differentialdiagnosis of lateral neck masses.Although malignant paragangliomasare possible, these tumors are usuallybenign. Nevertheless, treatment canlead to great morbidity and possiblemortality. The article by Drs. Hu andPersky addresses a multidisciplinaryapproach to these lesions.