| Popis: |
Head and neck surgery treats lesions from the skull base to the thoracic inlet. While most of these are malignant and require multimodal oncologic management, many are benign, but their treatment can be quite morbid due to their location. This anatomic area encompasses the special sense organs of sight, smell, taste, and hearing as well as the essential social function of speech and the vital processes of breathing and swallowing. The appearance of the face is often affected, and this can affect personal identity. In many clinical situations, survival outcomes are equal between radically different treatment paradigms, and medical decisions are predicated on anticipated survival and quality of life. Thus, it is critical to elicit accurate values and goals of care from patients and families facing these decisions. Narrative competence in describing and quantifying likely outcomes is an important skill for clinicians to cultivate, as is awareness of unconscious biases and the use of directive counsel. Even successful head and neck surgery has symptomatic sequelae that can be minimized with prehabilitation and managed with ongoing supportive care. |
