Pediatric Head and Neck Masses: Avoiding Pitfalls and Optimizing Outcomes

PROGRAM DESCRIPTION: Few things worry parents and referring clinicians as much as head and neck masses in children making this a relatively common complaint for both the general and pediatric otolaryngologist alike. These are often benign congenital lesions, infections, or reactive lymphadenopathy. But, as discussion of such masses is a routine part of the otolaryngology residency and pediatric fellowship, as they carry a small but devastating risk of malignancy, and as their complications bring significant cosmetic and functional consequences, there is little room for error in the diagnostic and therapeutic management of these children. From thyroglossal duct and branchial cleft cysts to chronic granulomatous lymphadenitis, from lymphoproliferative disorders to frank lymphoma, from thyroid to salivary neoplasms and many more, there are complex decisions in the clinical management of pediatric head and neck masses regarding imaging and tissue sampling protocols, timing of surgery versus age, malignancy risk, or anesthetic concerns, and counseling through observation periods. Once in the operating room, there are subtle nuances in our understanding of anatomy and approach that can prevent dreaded complications such as fistula, recurrence, airway compromise, and neurovascular injury. In this session, the codirectors of large pediatric head and neck tumor programs will discuss some of the common pediatric head and neck masses that form a component of many general and specialist practices with the aims to optimize evidence-based approaches to care, to review tips for safe and successful surgery, and to empower providers to most effectively counsel very nervous parents and primary care providers. The panelists will review available literature and share from their surgical experiences.

OUTCOME OBJECTIVE 1: Explain and utilize available evidence of diagnostic and therapeutic approaches to pediatric head and neck masses.

OUTCOME OBJECTIVE 2: Review anatomic considerations and surgical tools to avoid operative complications.

OUTCOME OBJECTIVE 3: Improve counseling and informed decision making in collaboration with parents of children with head and neck masses.

BACKGROUND STATEMENT: Commonly encountered problem for both comprehensive and pediatric otolaryngologist. The panelists see extensive referrals for these problems as they lead pediatric head and neck tumor programs. The session will be updated based on feedback from last year's well attended session.

Comprehensive Otolaryngology Track Statement : Although this session could be including in the comprehensive otolaryngology track as it is truly meant to educate all otolaryngologists on a common pediatric problem, it has been under the pediatric otolaryngology track since inception.