Primary Neck Cancers ‣ Anatomy

In order to fully understand primary neck cancers, it helps to understand the anatomy and function of the structures in the neck. The neck is a complex anatomic region between the head and the body.

In the front, the neck extends from the bottom part of the mandible (lower jaw bone) to the bones of the upper chest and shoulders (including the sternum and collar bones). The back of the neck is mostly comprised of muscles, as well as the spine. 

The neck is essentially a passageway for air, food, liquids, blood, and more to travel between the head and the rest of the body, through structures such as blood vessels, nerves, and lymph nodes, as well as the larynx, trachea, and esophagus. 

Important Structures in the Neck

Sternocleidomastoid Muscle
This is the large muscle on either side of the neck. This muscle covers and protects many important deeper structures such as the carotid artery and the jugular vein. This muscle starts at the skull just behind the ear (mastoid bone) and travels down to the sternum (breastbone) and clavicles (collarbones).

Thyroid Gland
The thyroid is located at the midline of the neck, under the skin and a few layers of thin muscles. It sits just in front of and to the side of the upper trachea. It secretes thyroid hormone which is important in regulating many functions of the body. The thyroid gland has a right and left lobe which are connected by an isthmus. Learn more about the thyroid.

Parathyroid Glands
These four glands are located just behind the thyroid gland, two on each side. They are critical in helping to regulate levels of calcium in the blood.

Carotid Sheath
This is an envelope of fascia that envelopes three major structures: the carotid artery, internal jugular vein, and vagus nerve.

Additional Major Arteries & Nerves
Just behind the carotid sheath sits the sympathetic nerve plexus, which helps with blood pressure control and other important functions. There are also other major nerves such as the hypoglossal nerve (which controls tongue movement), the spinal accessory nerve (which controls neck and shoulder movement), and the phrenic nerve that innervates the diaphragm (which facilitates breathing).

Larynx
The larynx is often called the voice box because it houses the vocal cords and is responsible for producing sound during speech. It is part of the throat and is located in the middle of the neck.  The framework of the larynx is formed by the cricoid and thyroid cartilage, as well as, other smaller cartilages. Learn more about the larynx.

Esophagus
The esophagus is the passageway for eating. It is located behind the trachea in the lower neck. Food and liquids travel through this muscular tube which travels from the neck through the chest until it connects to the stomach in the abdomen.  

Trachea
The trachea is the passageway for breathing. It begins just below the cricoid cartilage of the larynx and extends into the chest to eventually split into left and right bronchi which continue to divide in the lungs. The trachea is made up of multiple c-shaped cartilage rings and a posterior muscular wall.

Salivary Glands
The submandibular salivary glands and the tail of the parotid salivary gland are located in the upper part of the neck. Learn more about salivary glands.

Lymph Nodes
There are lymph nodes located throughout the body, and several in the neck. Lymph nodes filter fluid in the body and help to fight infections and cancers. Cancers from a site in the head and neck can drain into lymph nodes and lead to the growth of cancer within the lymph node (called a metastatic lymph node). Learn more about lymph nodes.

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Anatomy of the Throat and Neck

Because the parathyroid glands are located in the neck, any physician treating parathyroid problems must thoroughly understand the anatomy of the neck and throat. At the CENTER for Advanced Parathyroid Surgery in Los Angeles, we specialize in diagnosing and treating conditions of this complex part of the body. We find it helpful for our patients to understand the parts of the neck and throat. It’s also important to understand how the neck organs interact with and affect the rest of the body. 

In this guide, we’ll walk you through a diagram of the throat and neck. Do you have any further questions about the neck and throat? Contact us today to schedule a consultation with Dr. Babak Larian and the team at the CENTER for Advanced Parathyroid Surgery. 

A Diagram of the Throat and Neck 

Even though it may seem like common sense, some might be wondering, “Where is your throat located?” The throat is located in the front of the vertebrae in your neck. In the diagram below, you’ll see the parts of the neck and throat, each with its own number and corresponding label. Can you spot the parathyroid glands?   

Each parathyroid gland is roughly the size of a rice grain. There are four parathyroid glands located behind the thyroid, which is why they’re difficult to see in this diagram. We’ll take a closer look at the parathyroid glands in a moment. First, let’s explore the different parts of the human throat. Each structure is carefully examined when Dr. Larian diagnoses hyperparathyroidism or other parathyroid conditions. This helps Dr. Larian diagnose or rule out other conditions that affect the neck and throat. 

1. Jugular Veins

There are four primary jugular veins: two internal and two external. Jugular veins drain blood from the neck, face, and brain and return it to the heart.  The internal jugular veins are deep in the neck and the external jugular veins are immediately under the skin.

2. Vagus Nerves

Vagus nerves are connected to the heart, and digestive tract. They regulate digestion, heart rate, and other internal organ functions.

3. Carotid Arteries

Carotid arteries allow blood to travel to the neck, face, and brain. There are carotid arteries on each side of the neck. Those who place their hand on either side below the jaw line on the neck can feel the pulse of their carotid arteries.

4. Larynx (Voice Box)

The larynx is above the breathing tube that houses the vocal cords. Vocal cords don’t just create our voice. More importantly, they coordinate our breathing and swallowing. The top part of the larynx projects outward and can be felt (Adam’s apple).

6. Recurrent Laryngeal Nerve (RLN)

RLN is a branch of the vagus nerve that controls the movement of the voice box (larynx) muscles. It helps these muscles open and close and adjusts the tension of the vocal cords.

7. Trachea

The trachea, sometimes called the windpipe, is the airway that connects the voice box to airways that lead to the lungs (bronchi).

8. Thymus Gland

The thymus gland is located behind the sternum (breastbone) and in front of the heart. It produces progenitor cells that eventually become T-cells that can destroy cancerous or infected cells. The thymus gland also supports immune system development during the early years of life.

9. Aorta

The aorta supplies oxygenated blood to the circulatory system. It is the body’s main artery.

10. Lymph Nodes

There are hundreds of lymph nodes in the body. The lymph nodes are glands that filter & examine the fluid in-between cells. They contain immune cells that monitor for infections & cancers and attack and destroy any such abnormality.

Along with an evaluation of the anatomy of the throat and neck, the anatomy of the thyroid and parathyroid glands is examined to determine if a patient is dealing with HPT.

A Closer Look at the Thyroid and Parathyroid Glands

The thyroid and parathyroid glands may not have a direct relationship, but it’s helpful to look closely at these vital neck organs because they are so close together. The thyroid is a small, butterfly-shaped gland that produces hormones that regulate the body’s metabolism, temperature, and development. The parathyroid glands, located just behind the thyroid, produce parathyroid hormone (PTH), which regulates calcium in the bloodstream.

Any disruption to the thyroid or parathyroid glands can impact the entire body. If a thyroid or parathyroid gland stops working as expected, people are susceptible to various physical and emotional symptoms. 

An overactive thyroid can cause too much thyroid hormone (hyperthyroidism), resulting in symptoms like fatigue, muscle weakness, weight loss, diarrhea, and difficulty tolerating heat. Everything from inflammation of the thyroid (thyroiditis) to small growths on the thyroid can cause hyperthyroidism. When the thyroid doesn’t make enough thyroid hormone (hypothyroidism), patients can experience weight gain, dry skin, constipation, and difficulty tolerating cold temperatures. Thyroiditis, Hashimoto’s disease and recent pregnancy are all risk factors for hypothyroidism.  

When the parathyroid glands make too much parathyroid hormone (hyperparathyroidism), a person’s blood calcium levels rise (hypercalcemia). This can lead to joint pain, fatigue, nausea, frequent urination, confusion, and depression. In primary hyperparathyroidism, a benign tumor on one of the parathyroid glands or enlargement of multiple glands causes the glands to become overactive. On the other hand, secondary hyperparathyroidism happens when the body is calcium-deficient due to kidney failure or calcium deficiency. The parathyroid glands overcompensate for the low calcium levels by producing too much PTH. Hypoparathyroidism occurs when the parathyroid glands don’t make enough PTH. 

The thyroid gland is a crucial part of the neck and throat, and even though they’re much smaller, the parathyroid glands are essential, too. Any disturbance with either of these neck organs can wreak havoc on the body. Parathyroid conditions, in particular, can be challenging to diagnose because the symptoms caused by hyperparathyroidism are similar to the symptoms for a range of health conditions. At the CENTER for Advanced Parathyroid Surgery, Dr. Larian can provide the diagnostics and testing needed to figure out what’s going on with the parathyroid glands. He can also help rule out any other conditions affecting the parts of the human throat.

Impact of Parathyroid Disease on the Throat and Neck Anatomy

Parathyroid disease can occur for several reasons, including:

• Noncancerous growth on a parathyroid gland
• Abnormal growth (hyperplasia) of parathyroid cells in a parathyroid gland
• Cancerous tumor in a parathyroid gland

HPT occurs when one or more parathyroid glands produce an excess amount of PTH. In this instance, the body’s calcium level becomes unbalanced. The result: different structures of the neck and throat can stop functioning correctly.

The symptoms of HPT range in terms of severity. They can include:

• Chronic fatigue
• Bone pain
• Headaches
• Poor sleep
• Anxiety
• Depression
• Muscle weakness

HPT symptoms replicate those of many medical conditions. As such, it can be difficult to diagnose HPT.

For those who believe they are dealing with HPT, meeting with Dr. Babak Larian of the CENTER for Advanced Parathyroid Surgery is key. Dr. Larian is a parathyroid disease expert and can conduct extensive testing to determine if HPT is causing a patient’s symptoms. If a patient is dealing with HPT, Dr. Larian can perform minimally invasive parathyroidectomy (MIP) surgery to address the issue.

Advances in Throat and Neck Disorder Treatment

After learning more about the anatomy of the neck and throat, it might seem extra stressful to have surgery on your throat. But advances in surgical techniques mean that many types of throat surgery are minimally invasive procedures that do not require a hospital stay. In addition, minimally invasive techniques help lower the risk of complications, shorten recovery time, and reduce patient discomfort. These techniques often result in more positive outcomes for patients. 

Minimally invasive techniques in head and neck surgeries dealing with the sinuses, larynx, trachea, thyroid gland, and parathyroid glands are common. At the CENTER for Advanced Parathyroid Surgery, Dr. Babak Larian performs minimally invasive parathyroid surgery (parathyroidectomy) to treat hyperparathyroidism. He takes his time with each parathyroid surgery patient he treats, using intraoperative PTH testing to ensure a high cure rate. 

A highly experienced and empathetic head and neck surgeon, Dr. Larian can help patients understand what is happening with their parathyroid glands and other parts of the neck and throat. Dr. Larian is a parathyroid disease expert and can conduct extensive testing to determine if HPT is causing a patient’s symptoms. If a patient is dealing with HPT, Dr. Larian can perform minimally invasive parathyroidectomy (MIP) surgery to address the issue. 

If you are experiencing symptoms of hyperparathyroidism, you can meet with Dr. Larian to find out if you qualify for a MIP. For more information about parathyroid gland surgery, please contact us online or call us today at 310-461-0300 to schedule a consultation with Dr. Larian.

✳️ ️ Operation on the lymph nodes of the neck ✳️ ️ Surgical operations in the medical center “RISHON”

Neck dissection operation in Kharkiv: lymphadenectomy

Lymph nodes in the human body perform important functions, passing through the lymph flow and retaining pathogenic cells and microorganisms. In some cases, the malignant process from the primary focus in the thyroid gland spreads (metastasizes) to the regional cervical lymph nodes. With a proven metastatic lesion of the lymph nodes of the neck, it is necessary to perform surgical intervention in the volume of the cervical dissection. The operation of the cervical dissection, which is performed by surgeons in Kharkov at the Rishon Medical Center, is aimed at removing the lymph nodes affected by a cancerous tumor. Thanks to it, the further spread of malignant neoplasms can be avoided. The volume of the operation is planned depending on the type and prevalence of the malignant process, as well as the level of damage to the lymph nodes of the neck. In most cases, lymphadenectomy in our medical center is performed selectively. That is, fatty tissue with affected lymph nodes is removed, and tissues located nearby nerves, muscles or glands are not affected. Thus, the recovery period is reduced, and after the operation, the patient does not experience any restrictions. The use of cosmetic sutures and modern suture material practically does not leave scars and scars after surgery.

Information about the operation of lymphadenectomy

There are several hundred lymph nodes in the neck, through which metastases can spread. Previously, radical dissection was widely used, during which both nodes and adjacent tissues, muscle fibers, glands, blood vessels and nerves were removed. After such treatment, people had to put up not only with ugly scars, but also with serious restrictions in movement. At the moment, at the Rishon Medical Center in Kharkov, a selectively oriented neck dissection operation is practiced, which does not affect neighboring tissues and muscles. Note that the decision on the extent of surgical intervention is made by the surgeon after a detailed study of the diagnostic data. And if it turns out that the tumor has spread deep enough to cause significant damage, doctors may have to remove other parts of the neck:

• lateral neck muscles;
• veins to drain blood from the brain;
• salivary glands;
• nerves.

The specialists of our medical center in Kharkov, performing operations on the lymph nodes of the neck, do their best to cause minimal damage to the patient’s body. Immediately before the procedure, having studied in detail the data of diagnostic studies, the surgeon will definitely conduct a consultation. During the procedure, the patient learns exactly which areas of the neck will be affected, what are the possible side effects and limitations, and what should generally be expected after surgery.

Preparation and performance of cervical dissection surgery

To prepare for the operation, the doctor must refer the patient for diagnostics. The medical center “Rishon” in Kharkov has the necessary equipment for analysis and imaging of a cancerous tumor. But even if the lesion covers not only the lymph nodes, but also other tissues, surgeons perform a modified radical cervical dissection, during which the lymph nodes of all five levels are removed while preserving the anatomical formations: nerves, veins, muscles.

How is the operation on the lymph nodes of the neck performed: its main stages:

• marking the neck
• administration of anesthesia;
• removal of fatty tissue with affected lymph nodes;
• installation of drains to remove residual blood and lymph;
• layer-by-layer wound closure with cosmetic sutures.

The decision on the amount of surgical intervention is made by the doctor individually, based on the current condition of the patient and potential risks. Thus, cancer through the cervical lymph nodes is highly likely to spread when malignant neoplasms are detected in such organs as the salivary and parathyroid glands, tongue, larynx, nasopharynx, etc. In Kharkov, modified radical cervical lymph node dissection is performed using modern instruments and electrosurgical equipment, which allows specialists to carry out the operation safely and efficiently. In any case, the main task set by the specialists of our clinic is to prevent further spread of cancer to other organs and minimize postoperative side effects for patients.

Rehabilitation after neck surgery

Usually, after surgery, the patient needs only two days to recover in a hospital under the supervision of doctors. On the second day, the drains are removed. There are no special dietary restrictions. Even a radical modified cervical lymph node dissection, provided that it was performed by surgeons at a professional level, does not lead to any serious limitations. Except for those cases when it was necessary to remove the nerves and muscles responsible, for example, for turning the head or moving the tongue and hands. Functionality will return little by little after undergoing a course of rehabilitation and physiotherapy.

Thousands of patients have appreciated the benefits of treatment at the Rishon Medical Center:

• modern European-level service;
• adequate price level even when performing complex operations;
• professionalism of surgeons and medical personnel;
• the use of laparoscopic and endoscopic methods of treatment, after which there is no scar from incisions;
• modern laboratories and diagnostic equipment for detecting diseases at the earliest stages.

You can book your first consultation with a treating specialist online. Our managers will offer you a convenient time for a visit, as well as answer any questions regarding the cost of treatment and the scope of medical services provided.

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Sialoadenitis (inflammation of the salivary glands) – treatment, symptoms

In the human oral cavity, on the surface of the mucous membrane, there are three pairs of major salivary glands. One pair of them – parotid – are located in front and under the auricle. These are the largest salivary glands. The second pair – submandibular – is located under the lower jaw, slightly below the back teeth. The third pair – the sublingual salivary glands – are located under the mucous membrane of the bottom of the oral cavity on the left and right sides of the tongue.

All three pairs of salivary glands produce a specific secret – saliva. Saliva is produced in the body through special ducts located inside the oral cavity.

The main function of saliva in the body is to ensure normal and healthy digestion. Saliva softens hard pieces of food, preparing them for entry into the stomach. It also helps a person to swallow these softened food pieces.

If a person develops inflammation of the salivary glands, saliva ceases to perform its main function. The process of saliva production fails, swallowing food becomes more and more difficult.

If you experience pain, inflammation, bleeding gums, do not wait until the symptom goes away. You can muffle it with painkillers, but it is impossible to stop the inflammatory process without the intervention of a specialist! Contact your dentist for a consultation. Dentistry on Shchelkovskaya Diamed is located near the Shchelkovskaya metro station. We work for you seven days a week. You can make an appointment with a dentist by calling 8 (495) 221-21-18 or by filling out the online registration form.

Why inflammation of the salivary glands begins

Inflammation of the salivary glands occurs in two types.

Epidemic sialoadenitis

Epidemic sialadenitis is caused by viral diseases and infections. A common cause of inflammation of the salivary glands is mumps. The virus in this disease passes from one person to another by airborne droplets. The inflammatory process in the salivary glands occurs with a strong increase in their size.

Non-epidemic sialadenitis

Another cause of inflammation of the salivary glands is the formation of blockage of the salivary duct. Violations in the functioning of the duct can occur due to severe mechanical injuries, the ingress of foreign bodies into them, the development of salivary stone disease in humans – sialolithiasis.

A very common reason for the development of inflammation of the salivary glands is the irregular observance of the rules of oral hygiene. Non-epidemic parotitis – this is what inflammation of the parotid salivary glands is called in medicine – can occur as a result of the transfer of an infectious disease (pneumonia, influenza, typhoid, encephalitis are at risk) or as a result of surgical intervention.

How sialadenitis manifests itself

The most common symptoms of inflammation of the salivary glands include:

• pain during eating, swallowing food;
• redness, swelling of the face or neck;
• disturbance of taste sensations;
• the presence of an unpleasant aftertaste in the oral cavity;
• dry mouth;
• difficulty opening the mouth;
• the appearance of shortness of breath;
• general increase in body temperature.

It should be borne in mind that in acute sialoadenitis, the symptoms subside as quickly and abruptly as they appear. But this is not a reason to forget about the problems that have only recently tormented you. The fact is that the disease does not go away, but only goes into a quiet stage, which can subsequently lead to the development of chronic sialadenitis.

Sialadenitis can be accompanied by complications if you do not start treatment on time or do not follow all the instructions of the attending physician. The most common complications include:

• formation of pustules on the floor of the mouth;
• abscess (purulent inflammation) of salivary glands;
• re-infection.

Diagnosis and treatment of inflammation of the salivary glands

How sialadenitis is diagnosed

Diagnosis of sialoadenitis by a dentist during an oral examination or by a general practitioner if you go to a multidisciplinary clinic with the disease. During the examination, a significant increase in the salivary glands is usually detected, sometimes – the release of purulent fluid. In the case of a bacterial infection, soreness of the salivary glands is revealed.

If the attending physician suspects an abscess, the patient will usually order an ultrasound. Our Dentistry is located in the same building as the multidisciplinary clinic “Diamed” on Schelkovskaya. You will be able to quickly receive treatment and undergo the necessary diagnostic and therapeutic procedures.

Treatment of sialadenitis

Sialoadenitis is easier to treat when the disease is acute and has not become chronic.

The treatment of acute sialadenitis consists in the use of special drugs that increase the secretion of salivary fluid. In the treatment of sialoadenitis, an important place is occupied by physiotherapeutic procedures, in particular ultra-high frequency therapy (UHF) and laser physiotherapy. After the start of physiotherapeutic procedures, relief occurs already on the third day, and on the 7th day the disease completely disappears. The physiotherapy room is located in the same building as our dentistry, you will be directed to an appointment with a specialist physiotherapist for a free consultation.

During the treatment period, it is very important to observe all the rules of oral hygiene. It is recommended to brush your teeth not only in the morning and evening, but also to clean after each meal with dental floss. Compliance with this rule helps prevent the further development of inflammation. For the period of treatment, smokers are strictly required to get rid of their bad habits.

It is very correct to follow the diet during the treatment. The food you eat should be cut into small pieces. Also, a positive effect on the salivary glands has an abundant use of warm liquids – milk, rosehip broth, exclusively fresh juices and fruit drinks.

If you have a fever, your doctor will prescribe antipyretic and anti-inflammatory drugs.

Chronic sialoadenitis is difficult and long to treat.