Glossary

Hearing & Balance Center

Auditory nerve – bundle of nerve fibers that carry electrical impulses between the inner ear and the brain

Auditory Canal – also called the ear canal, it conducts sound toward the eardrum

Cochlea – part of the inner ear, contains fluid and hair-like nerve cells that convert mechanical energy from the middle ear into electrical impulses

Conductive Hearing Loss – any hearing loss caused by damage or disease in the outer or middle ears

Eustachian Tube – a tube that extends from the middle ear to the roof of the throat; it keeps the air pressure in the middle ear consistent with the air pressure in the immediate environment

Incus – the anvil shaped bone; middle bone of the ossicular chain (the three tiny bones that connect the eardrum and the inner ear)

Inner Ear – part of the ear that contains the cochlea, an organ of hearing, and the labyrinth, an organ of balance

Mastoid – the section of the skull located behind the outer ear that houses the middle and inner ears

Malleus – the hammer shaped bone; outermost of the ossicles, the three tiny bones that connect the eardrum and inner ear

Middle Ear – the air-containing cavity of the ear; lying between the eardrum and the inner ear, it includes the eardrum and the ossicles, which are the three tiny bones called malleus, incus and stapes

Ossicles – a linkage of three tiny bones - the malleus, incus and stapes, also known as the hammer, anvil and stirrup; they provide the mechanical coupling between the eardrum and the cochlea

Outer Ear – the part of the ear that captures sound; it is composed of the visible parts of the ear and the canal leading to the eardrum

Semicircular Canals – the body's balance organs, they detect the body's movement and communicate its position to the brain

Sensorineural Hearing Loss – hearing loss caused by damage or disease in the inner ear

Stapes – the stirrup-shaped ossicle that transmits sound from the incus to the cochlea; the innermost of the ossicles

Temporal Bone – the temporal bones form part of the base of the skull; among the hardest of all the bones, it includes the mastoid and protects the hearing and balance systems

Tinnitus – the sensation of a ringing, roaring, or buzzing in the ears or head; it is often associated with many forms of hearing impairment and noise exposure

Tympanic Membrane – also called the eardrum, it separates the ear canal from the middle ear, vibrating when sound waves hit it

Vertigo – a false sensation of motion or spinning that leads to dizziness and discomfort

Head & Neck Surgery Center

Aerodigestive Tract

What is the Aerodigestive Tract?

The combined tissues and organs of the upper part of the digestive tract and the respiratory tract are defined as the aerodigestive tract. Included in the aerodigestive tract are the oral cavity (mouth), pyriform sinus, larynx, pharynx, esophagus, as well as the nose and sinus tract. So essentially the aerodigestive tract is the region in the throat and oral cavity where both food and air pass. Helping us serve the functions of speaking, eating, and breathing during our waking and sleeping hours.

Disorders of the Aerodigestive Tract

A complex condition that can affect the upper airway, lungs, as well as the digestive tract, aerodigestive disorders can affect a person’s ability to eat, swallow, and breathe. Common disorders of the aerodigestive tract (mouth, nose, throat, esophagus, lungs, and stomach) include:

Esophageal Disorders

• Achalasia • Caustic ingestion • Colonic interposition • Eosinophilic Esophagitis (EoE) • Esophageal atresia • Esophageal diverticula • Esophageal duplication • Esophageal dysmotility disorders • Esophageal strictures • Esophageal webs • Gastroesophageal Reflux Disease (GERD) • Tracheoesophageal Fistula (TEF)

Pulmonary Disorders

• Aspiration • Bronchomalacia

Upper Airway Disorders

• Laryngeal cleft • Laryngeal web • Laryngeal stenosis • Severe laryngomalacia • Vocal fold paralysis

Symptoms of an Aerodigestive Disorder

Symptoms that can indicate an aerodigestive disorder include:

• Resistant asthma • Coughing (chronic) • Failure to thrive • Frequent vomiting, or regurgitation of food • Croup (barking cough-recurrent) • Respiratory infections (recurrent) • Noisy, high-pitched breathing • Choking episodes • Painful or difficult swallowing (dysphagia) • Reflux that affects the airway

How is an Aerodigestive Disorder Diagnosed?

If you want your plan of care to be effective, you need to have an accurate diagnosis. The following state of the art tools are currently used to make an accurate diagnosis of an aerodigestive disorder.

• Chest and/or neck CT scan • Chest x-ray • Airway fluoroscopy • Video swallow study • Upper GI (gastrointestinal tract) x-ray • FEES (fiberoptic endoscopic evaluation of swallowing) • Pulmonary function testing (PFT) – both exercise-induced and endoscopic-assisted PFT

Anaplastic Thyroid Cancer – highly aggressive type of thyroid cancer; thankfully rare

CT Scans – computerized X-Ray often used for diagnosis of head and neck tumors

Endocrinologist – non-surgeon medical doctor specializing in glands

Endoscopy – evaluation of any area using lighted telescope; it can be flexible or rigid

Erythroplakia – red discoloration of tissue

Esophagus – food pipe that extends from the pharynx to stomach

Fine Needle Aspiration – placement of fine needle into tissues to obtain cells which are then reviewed for diagnosis

Follicular Thyroid Cancer – second most common cancer of the thyroid gland

Hyperthyroidism – overactive thyroid gland

Hemithyroidectomy – Hemithyroidectomy is a surgical procedure that removes half of the thyroid gland. During this procedure, one of the lobes and part of the isthmus is removed. An endocrine gland, the thyroid gland produces two major hormones that are responsible for various bodily functions, calcitonin, triiodothyronine (T3), and thyroxine (T4). Thyroid hormones have an impact on every organ and every cell of the human body, controlling the speed at which your body cells work. Thyroid hormones regulate the body's metabolism, body weight, heart rate, muscles, bone loss, menstrual cycles, breathing, blood lipid levels, body temperature, the nervous system, and more. In some instances, a thyroidectomy has to be performed, removing all or part of the thyroid gland. The reasons for performing a hemithyroidectomy includes:

  • Hyperthyroidism- When the thyroid gland is hyperfunctioning or producing too much of the thyroid hormone.
  • Cancer- If thyroid cancer is suspected, one of the lobes are removed so it can be analyzed for a determination.
  • Compression- When a nodule in the thyroid becomes enlarged it can compress surrounding structures in the neck. Including the esophagus or trachea.
  • Cosmetic Reasons- For some people, the thyroid gland can create an unsightly lump in the front of the neck.
When a hemithyroidectomy is performed, general anesthesia is used. Dissection is made on one of the skin creases in the neck to reach the thyroid gland. A surgical drain is inserted and is required for, at least, the first night after surgery. Usually, on the second day after the operation, the draining has stopped and the surgical drain is able to be removed. Once the surgical drain has been removed, it is then possible to return home to continue your post-op care. After a hemithyroidectomy, the length of time that is required to recover can vary, but often it is one to two weeks. Fortunately, most people recover fairly quickly after a hemithyroidectomy.

Larynx – voice box

Laryngoscope – lighted telescope used to visualize the larynx or voice box; either flexible (fiber optic) or rigid (open tune)

Medullary Thyroid Cancer – third most common cancer of thyroid, may have hereditary component

MRI – MRI stands for magnetic resonance imaging, and it is a computerized imaging technique that uses magnetic and radio waves rather than ionizing radiation (x-rays) to produce detailed images of the inside of your body. Detailed pictures of bones, tissues, organs, and internal body structures can be seen, allowing doctors to determine the presence of disease. MRI's can be used when you are pregnant to monitor the baby and are also used to help diagnose and monitor treatment for a variety of conditions. This kind of medical test is noninvasive and helps physicians diagnose all kinds of medical conditions. The produced digital images are able to be viewed on a computer monitor, where they then can be transmitted electronically, uploaded to a cloud server, burned to a CD, saved to a jump drive, or even printed.

Some of the Conditions That Cen Be Diagnosed or Monitored Using an MRI

• Pregnancy • Multiple sclerosis • Heart problems (i.e., congenital heart disease) • Tumors • Inflammatory bowel disease (i.e., ulcerative colitis and Crohn’s disease) • Inflammation and malformations of the blood vessels • Diseases of the liver • Stroke • Abnormalities of the pancreas • Joint abnormalities

How to Prepare for an MRI

There is not a lot of preparation for an MRI exam. Unless instructed otherwise, you can still eat and take your normal medications as directed. To help prevent valuables such as jewelry from being lost or stolen, leave them at home. Jewelry will have to be removed prior to entering the scan room, as well as any hairpins, dentures, hearing aids, eyeglasses, watches, wigs, and underwire bras. To help eliminate possible safety issues, wear comfortable, metal-free clothing that is loose-fitting. Also, because some cosmetics contain metallic substances, you should not wear any makeup to your appointment. Be sure to arrive 15 to 30 minutes prior to your exam. Upon checking in with the receptionist, you may have to complete an MRI screening form and other paperwork. Come prepared with your identification, insurance card(s), as well as a list of your current medications (if any). If you are pregnant or if there is a possibility you could be pregnant, have an allergy to iodine, have any serious health problems, or have had any recent surgeries, tell the radiologist.

Mucosa – lining of body tubes

Oral cavity – mouth

Oropharynx – Posterior part of oral cavity

Papillary Thyroid Cancer – Most common type of thyroid cancer

Parathyroid Adenoma – benign tumor of parathyroid gland, usually affecting one to four glands and causes elevated calcium levels

Parathyroid hyperplasia – overgrowth of all (four) parathyroid glands, also causes elevated calcium levels

PET Scans – computerized imaging uses glucose metabolism to identify tumors.

PET/CT Scans – Combination of PET scanning with CT scanning to better identify tumors

Pharynx – Area of throat between oral cavity and vocal cords

Sestamibi Scan – imaging technique used to isolate overactive parathyroid gland or glands

Squamous Cell Carcinoma – common tumor of upper aerodigestive tract; causally-related to smoking and drinking

Thyroid adenomas – benign tumor of thyroid gland

Thyroid goiters – large, multi-cystic thyroid gland

Trachea – Windpipe

Facial Plastics Center

Blepharoplasty – Surgery of the eyelids in which fat and excess skin, bags, pouches, wrinkles in the eye area are removed.

Botulinum Toxin Botox – Injected to relax facial muscles temporarily to eliminate wrinkles for three to six months.

Cheek / Chin Augmentation – Surgery where implants are placed in the cheeks or chin to improve bone structure, balance a profile, or support sagging, soft tissues.

Chin Augmentation – See Cheek / Chin Augmentation

Chemical Peels – Resurfacing of the skin with an acid solution that peels the top layers and allows smoother, regenerated skin to emerge; an effective treatment for wrinkles caused by sun damage, mild scarring, and certain types of acne.

Collagen Implant – An injection of natural protein, which raises skin tissue to smooth the skin and make wrinkles and scars appear less visible.

Dermabrasion – A facial sanding technique used to treat deep scars and wrinkles, raised scar tissue, and some severe cases of cystic acne; top layers of skin are "sanded" off with a high-speed rotating brush or a diamond-coated wheel.

Facial Reconstruction – Surgery to repair or reconstruct facial features in victims of cancer, facial trauma, and birth defects.

Filler Injections

What are Facial Fillers/Injections?

Most commonly collagen – a gel-like substance derived from purified animal tissue, and fat – which is harvested from the patient’s thigh or abdomen and then injected to plump up facial areas or “fill” wrinkled areas (see also Botox). Facial fillers can also include calcium hydroxylapatite and hyaluronic acid. Ranging from a temporary to a long-lasting solution, facial fillers are administered through facial injections on specific areas of the face. There are various types of fillers available as each one is designed with one or several purposes, but a qualified professional can help you determine which facial injections are right for you. Depending on the individual and the number of areas being treated, filler injections can take about 10 to 20 minutes per session. Luckily, facial fillers don’t require a large amount of downtime. Typically, directly following treatment patients can return to work and their normal activities, but this will vary depending on the individual and the type of injectable filler used. In some cases, for the first 24 hours after treatment, certain individuals will be instructed to refrain from excessive heat or sun exposure, and strenuous activities.

Why Use Facial Fillers?

It’s natural that as we age, our skin becomes more susceptible to sagging and wrinkles as the years of muscle movement (from smiling, chewing, speaking, squinting, etc.) and sun exposure contributes to the breakdown of skin tissue. However, skin can be rejuvenated through the use of filler injections. Facial injections can replace soft-tissue volume loss, raise scar depressions, enhance the lips (lip augmentation), and can help reduce or eliminate wrinkles. Injections can help create a younger look in the face by volumizing the folds and creases that have formed due to the loss of fat and collagen.

Common Side Effects of Filler Injections

Some of the common side effects of facial fillers/injections include:

• Swelling • Tenderness/pain • Numbness • Redness • Itching • Discoloration • Bruising at the injection site • Allergic reaction

Browlift/Forehead Lift – Surgery to minimize forehead lines and wrinkles, and to elevate brows to reduce lid drooping.

Forehead Lift – See Browlift/Forehead Lift

Liposuction – Surgery to reduce excess fatty deposits.

Mentoplasty – Surgery to balance a profile by enlarging, reducing, or reshaping the chin.

Microdermabrasion – A mini-peeling with minimal risk of dyspigmentation or scarring that is achieved by projecting aluminum micro-crystals onto the skin (also referred as the "Power Peel," "Euro Peel", "Parisian Peel" or "Derma Peel"); safe for all skin types.

Otoplasty

What is an Otoplasty?

Also known as cosmetic ear surgery, otoplasty is a procedure to change the size, shape, and position of the ears. Maybe your ears stick out too far from your head, or maybe one or both of your ears are misshapen due to a congenital disability or an injury. With an otoplasty, deformed or protruding ears are able to be “pinned back” by reshaping the cartilage. While an otoplasty is often performed on both ears to ensure symmetry, having this procedure done will not alter your ability to hear, and it will not change the location of your ears. Usually, after the age of 5, the ears have reached their full size, so an otoplasty, if necessary, can be done at any age after this. However, in some instances, an otoplasty surgery can be done as early as the age of 3. If a child is under the age of 3 and was born with prominent ears or some other ear-shape issues, these issues might be able to be corrected with the use of a splint. Especially if they are started immediately after the child is born.

Why is an Otoplasty Done?

An otoplasty might be considered if the person has any of the following:

• Dissatisfaction with a previously done ear surgery • One or both ears stick out far from your head • In proportion to your head, your ears are too large

What are the Risks?

Just like any type of surgery, there is a risk of infection, excess bleeding, and an adverse reaction to anesthesia can occur.

• Unnatural contours of the ear can occur, making the ear(s) appear to be pinned back onto the head. • Scarring can happen, but the scars are likely to be hidden within the creases of the ears and behind the ears. • While rarely permanent, you can experience changes in skin sensations on your ears. • Even after surgery, you may still experience asymmetry in ear placement.

Rhinoplasty – Aesthetic surgery of the nose in which cartilage and bone are reshaped and reconstructed; excess bone or cartilage may be removed.

Rhytidectomy – Facelift surgery in which excess skin is removed and muscles are tightened.

Scar Revision Surgery – Procedures to help minimize visible facial scars.

Septorhinoplasty – A form of rhinoplasty that is performed to reconstruct the nasal passage or to relieve obstructions inside the nose to correct breathing problems; the obstruction is removed through internal incisions and the interior of the nose is restructured.

Skin Resurfacing – Removal of the outer layer of the skin using abrasion, chemicals, or a laser, resulting in smoother and less wrinkled skin.