Emil Theodor Kocher and Theodor Billroth pioneered the surgical management of thyroid disease. Their surgical techniques, knowledge of thyroid anatomy, embryology, histology, physiology, and antisepsis practices transitioned a life-threatening operation to one with acceptable morbidity. The modern head and neck surgeon should have a meticulous surgical technique, combined with a thorough understanding of thyroid embryology and anatomy that is central to the understanding and treatment of the different disease processes of the thyroid gland and the consequences of thyroid gland surgery. In this manuscript we will be examining thyroid gland embryology, anatomy, histology, and physiology that is essential to the practicing thyroid surgeon.

Thyroid nodules are a major health problem worldwide. The prevalence of palpable thyroid nodules in the general population is approximately 5% in women and 1% in men living in parts of the world with sufficient iodine. High resolution neck and thyroid ultrasound can detect thyroid nodules in a significant proportion of randomly selected individuals, with higher frequencies in women and the elderly population. The importance of thyroid nodules lies in the need to rule out cancer. The majority of thyroid nodules are benign, clinically irrelevant, and can be safely managed with a good surveillance program. The detection and diagnosis of differentiated thyroid cancer have evolved over the years with increased use of high resolution cervical and thyroid ultrasound, fine needle aspiration biopsy (FNAB), molecular testing, and thyroglobulin as a serum tumor marker. An algorithm that utilizes high resolution ultrasound and, when indicated, FNAB, and molecular testing for the diagnosis of thyroid nodules, facilitates a personalized, risk-based protocol that promotes high-quality care and minimizes cost and unnecessary testing. Our paper reviews the current, evidence-based management of newly diagnosed thyroid nodules.

In 2018, it is estimated that about 51, 540 new cases of oral cavity and pharyngeal cancer will develop, which represent approximately 3-5% of all cancers in the United States. During the same time period it is estimated that there will be approximately 10, 030 deaths. Incidence rates are more than twice as high in men as in women (Male cases-37,160, Female cases-14,380). From 2006 to 2010 incidence rates remained stable in men and have decreased by 0.9% per year in women. Oral tongue cancer requires a multidisciplinary approach to treat it that includes a surgical oncologist, a medical oncologist, a radiation oncologist, speech therapists and physical rehabilitation as well as emotional support through the help of psychologists or social workers. In this review paper we will discuss current management of these complex tumor.

Medullary Thyroid Carcinoma (MTC) accounts for approximately 1.7% of all thyroid malignancies. The majority of MTC are sporadic, but 15% to 25% of the cases result from a germline mutation in the RET proto-oncogene. Surgery is the first-line treatment modality for any patient presenting with respectable MTC. The propensity of MTC to metastasize to regional lymph nodes in the central and lateral compartments of the neck is a defining characteristic of this disease, which explains the surgical management in all clinical settings. Elimination of involved nodes can result in longterm cure or disease control, and a working knowledge of cervical lymph node anatomy and of the natural history of MTC spread within these nodal groups is important to the surgeon managing these patients. The degree and timing of the surgery are discussed centered on evidence-based medicine this case report and literature review discusses the contemporary management approach used for the evaluation, diagnosis and treatment of our patient with MTC.

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