The neck is the part of the body on many limbed vertebrates that distinguishes the head from the torso or trunk.

Anatomy of the human neck

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Bony anatomy: The cervical spine

The cervical portion of the human spine comprises seven bony segments, typically referred to as C-1 to C-7, with cartilaginous disks between each vertebral body. The neck supports the weight of the head and protects the nerves that travel from the brain down to the rest of the body. In addition, the neck is highly flexible and allows the head to turn and flex in all directions. From top to bottom the cervical spine is gently curved in convex-forward fashion. It is the least marked of all the curves of the column.

Soft tissue anatomy

In the middle line below the chin can be felt the body of the hyoid bone, just below which is the prominence of the thyroid cartilage called "Adam's apple," better marked in men than in women. Still lower the cricoid cartilage is easily felt, while between this and the suprasternal notch the trachea and isthmus of the thyroid gland may be made out. At the side the outline of the sternomastoid muscle is the most striking mark; it divides the anterior triangle of the neck from the posterior. The upper part of the former contains the submaxillary gland, which lies just below the posterior half of the body of the jaw. The line of the common and the external carotid arteries may be marked by joining the sterno-clavicular articulation to the angle of the jaw.

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Head & Neck

Altered fractionation and adjuvant chemotherapy for head and neck squamous cell carcinoma
William M. Mendenhall, Charles E. Riggs, Mikhail Vaysberg, Robert J. Amdur, John W. Werning Thu, 05 Nov 2009 14:53:00 -0000
The aim of this review was to discuss the role of altered fractionation and adjuvant chemotherapy for patients treated with definitive radiotherapy (RT) for head and neck squamous cell carcinoma (HNSCC).This review explores the pertinent literature and discusses the optimal management of previously untreated patients with stage III-stage IVA and/or -B HNSCCs.Depending on the schedule, altered fractionation improves locoregional control and survival. Both hyperfractionation and concomitant boost RT improve locoregional control and are associated with improved overall survival (OS). Adjuvant chemotherapy improves OS; the greatest impact is observed after concomitant versus induction or maintenance chemotherapy. Monochemotherapy appears to be equivalent to polychemotherapy. Drugs associated with the greatest survival benefit include fluorouracil and cisplatin. Intraarterial chemotherapy offers no advantage over intravenous chemotherapy. Concomitant cetuximab and RT results in improved outcomes similar to those observed after concomitant cisplatin-based chemotherapy and RT.Altered fractionation and/or concomitant chemotherapy result in improved outcomes compared with conventionally fractionated definitive RT alone for stage III-stage IV HNSCC. The optimal combination of RT fractionation and chemotherapy remains unclear. © 2009 Wiley Periodicals, Inc. Head Neck, 2009
Meeting Report - The NIDCR 2nd Salivary Gland Tumor Meeting, November 2008
Adel K. El-Naggar, Frederic J. Kaye, Yasaman Shirazi, J. Silvio Gutkind, Arlene A. Forastiere Tue, 03 Nov 2009 14:22:00 -0000
No abstract.
Immunostaining patterns of CD31 and podoplanin in previously untreated advanced oral/oropharyngeal cancer: Prognostic implications
Andrea Bolzoni Villaret, Alberto Schreiber, Fabio Facchetti, Simona Fisogni, Silvia Lonardi, Davide Lombardi, Daniela Cocco, Luca Oscar Redaelli de Zinis, Piero Nicolai Tue, 03 Nov 2009 14:22:00 -0000
The objective of this study was to assess angiogenesis and lymphangiogenesis patterns in advanced oral/oropharyngeal cancer by immunohistochemical techniques.Forty-five patients with advanced oral/oropharyngeal cancer, treated by primary surgery between January 1996 and December 2005, were selected. All cases were followed for at least 24 months. Angiogenesis and lymphangiogenesis were evaluated with antibodies against CD31 and podoplanin, respectively. Survival outcomes were calculated by the Kaplan-Meier method, whereas univariate comparisons were obtained by log-rank, chi-square, and Mann-Whitney tests.Survival correlated with the area of peritumoral blood vessels (p = .02), whereas the number of intratumoral lymphatics (p = .02) correlated with the occurrence of nodal metastasis. The risk for distant metastasis correlated with the perimeter of intratumoral lymphatics (p = .02).Peritumoral angiogenesis presented different expression patterns between survivors and patients who died of disease. Intratumoral lymphangiogenesis was correlated with a higher risk of developing lymph node (LN) and distant metastasis. © 2009 Wiley Periodicals, Inc. Head Neck, 2009
Complementary and alternative medicine use in patients presenting to a head and neck oncology clinic
Tarren Vyas, Robert D. Hart, Jonathan R. Trites, Timothy J. Philips, Kathleen E. M. Archibald, Judith E. Phillips, S. Mark Taylor Tue, 03 Nov 2009 14:22:00 -0000
The aim of this study was to determine the prevalence of complementary and alternative medicine (CAM) use among patients presenting to a head and neck oncology clinic prior to a diagnosis.The study was conducted by administering questionnaires to 102 patients after being seen in the Head and Neck Oncology clinic for their initial consultation. The questionnaire assessed the extent of CAM use, types of CAMs used, and their reasons for use.A total of 132 CAMs were currently being used among 56 patients. The most common CAMs in use were multivitamins (26/132) and vitamin D (21/132). Meditation and yoga were associated with the greatest perceived benefit. The majority of patients obtained their information from family and friends. Most patients were using CAMs for physical health and well-being.As CAM use among the population is widespread, it is important for clinicians to specifically address their use on initial presentation. © 2009 Wiley Periodicals, Inc. Head Neck, 2009
Detection of metachronous esophageal squamous carcinoma in patients with head and neck cancer with use of transnasal esophagoscopy
Yan-Ye Su, Fu-Min Fang, Hui-Ching Chuang, Sheng-Dean Luo, Chih-Yen Chien Tue, 03 Nov 2009 14:22:00 -0000
The use of transnasal esophagoscopy was examined for detecting metachronous esophageal squamous carcinoma in patients with head and neck squamous cell carcinoma (HNSCC).In all, 398 transnasal esophagoscopies were performed in 293 previously treated patients with HNSCC between December 2007 and January 2009.Metachronous esophageal squamous carcinoma was detected in 15 (5.1%) patients. The prevalence rate was 15.9% (7/44) in patients with hypopharyngeal cancer, significantly higher than the 8.3% (2/24) with laryngeal, 7.1% (3/42) with oropharyngeal, and 1.6% (3/183) with oral cancer (p = .001). The stage distributions of esophageal squamous carcinoma were I-II in 12 (80%) and III-IV in 3 (20%) patients. Subsequently, curative strategies were performed in 13 (87%) patients.Transnasal esophagoscopy can be used as a routine survey technique in patients with HNSCC to detect metachronous esophageal squamous carcinoma, especially in those with hypopharyngeal cancer. © 2009 Wiley Periodicals, Inc. Head Neck, 2009
Accelerated fractionation radiotherapy and late intensification with 2 intra-arterial cisplatin infusions for locally advanced head and neck squamous cell carcinoma
Kwok Hung Yu, Simon C. H. Yu, Edwin P. Hui, Michael K. M. Kam, Alexander C. Vlantis, Edmund Yuen, Anthony T. C. Chan Mon, 02 Nov 2009 15:34:00 -0000
This study was established to determine the maximum tolerated dose of intra-arterial cisplatin (IAC) concurrent with accelerated fractionation radiotherapy for locally advanced head and neck squamous cell carcinoma (HNSCC).We conducted a phase I study. Treatment consisted of 70 Gy/35 fractions/5.8 weeks and 2 weekly IAC infusions during the last 2 weeks.Ten patients were recruited. Two patients had stage III, 1 had stage IVa, and 7 had stage IVb disease. Three patients received IAC at 100 mg/m2, 3 at 125 mg/m2, and 4 at 150 mg/m2. Nine patients received both planned infusions. Dose-limiting toxicity occurred at 150 mg/m2 as transient grade 4 leukopenia and prolonged grade 3 acute skin reactions. The maximum tolerated dose was 125 mg/m2. Six patients survived disease-free at 39 to 67 months.It was feasible to give IAC concurrent with accelerated fractionation radiotherapy for locally advanced HNSCC. The maximum tolerated dose of cisplatin was 125 mg/m2. © 2009 Wiley Periodicals, Inc. Head Neck, 2009

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