This book provides a practical guide to decision making in head and neck oncologic surgery. As new technology is introduced, there is increasing knowledge regarding the efficacy of traditional head and neck surgical therapies and how to select among these varied and complex approaches is becoming increasingly difficult. Concise easy to follow chapters are devoted to one or two specific questions or decisions in head and neck oncologic surgery, aiding the reader to develop their decision making skills.

Difficult Decisions in Head and Neck Oncologic Surgery is a timely reference source for practicing surgeons, surgeons in training, and educators on the recommended ideal approaches in selected clinical situations. 

1. Evidenced based-medicine

2. Decision analytic techniques
3. Decision making from a physician perspective
4. Decision making from a patient perspective
5. Elective versus therapeutic neck dissection for clinically node negative oral cavity cancer
6. Management of moderate dysplasia of the oral cavity
7. Ideal resection margins in oral cavity cancer
8. Should margin sampling be obtained from the specimen or from the resection bed?
9. Should level IIb undergo routine dissection in clinical node negative oral cavity cancer
10. Sentinel node biopsy or elective neck dissection for clinical node negative oral cavity cancer
11. Surgical or non-surgical treatment for advanced oral cavity cancer
12. Management of early T-stage oropharyngeal cancer
13. Surgical management versus chemoradiation for unknown primary tumor
14. Should treatment deintensification be routine for HPV associated oropharyngeal cancer
15. Early oral feeding following primary total laryngectomy
16. Up-front surgery or organ preservation for advanced laryngeal cancer
17. What is the best treatment paradigm for advanced larynx cancer with oligometastatic disease?
18. Surgery or radiation therapy for early stage glottic cancer
19. Should thyroid cancer with distant metastatic disease be treated with curative or palliative intent
20. What is the optimal management of papillary thyroid microcarcinoma?
21. Should routine central neck dissection be performed for thyroid carcinoma?
22. When should one operate on anaplastic thyroid cancer?
23. Should pre-operative embolization be utilized routinely for carotid body tumors prior to surgical resection?
24. Vagal paraganglioma and schwannoma-  surgical or non surgical management?
25. Parotid malignancy with facial paresis- should the facial nerve be sacrificed?
26. Adjuvant management of advanced high grade parotid malignancy
27. Is parotidectomy indicated in cutaneous exteral auditory canal cutaneous skin cancer?
28. What is the ideal resection margin in head and neck Merkel cell carcinoma
29. Basosquamous cutaneous cancer- should routine neck dissection be offered?
30. Is routine anti-coagulation warranted following free flap reconstruction?
31. Does two venous anastamosis lead to better outcomes in free flap reconstruction
32. Reconstruction for early tongue cancer
33. Should reconstruction be staged with cutaneous melanoma of the head and neck?
34. Prophylactic versus reactive gastrostomy tube placement for advanced head and neck cancer
35. Is routine physical therapy warranted following neck dissection
36. What is the best time interval for obtaining surveillance imaging following non-surgical treatment of head and neck cancer?
37. What is the best imaging modality to predict extracapsular nodal extension?
38. Is there a role for triple endoscopy in the staging of head and neck cancer?
39. Is there a role for induction chemotherapy in advanced head and neck cancer
40. Is routine carotid imaging warranted following radiation treatment of head and neck cancer.