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Head and Neck Anatomy

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OXFORD HANDBOOK OF

Head and Neck

Anatomy
FIRST EDITION

Daniel R. van Gijn (Author)

Specialist Registrar Oral and Maxillofacial Surgery
Royal Surrey County Hospital, Guildford, UK

with
Jonathan Dunne (Co-​author)
Consultant Plastic and Reconstructive Surgeon
Charing Cross Hospital
Imperial College Healthcare NHS Trust, London, UK

consultant editors
Susan Standring
Emeritus Professor of Anatomy, Department of Anatomy
King’s College London, UK

Simon Eccles
Consultant in Craniofacial Plastic and Reconstructive Surgery
Chelsea and Westminster Hospital NHS Foundation Trust,
London, UK

1
iv

1
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First Edition Published in 2022
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and you must impose this same condition on any acquirer
Published in the United States of America by Oxford University Press
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ISBN 978–​0–​19–​876783–​1
DOI: 10.1093/​med/​9780198767831.001.0001
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To my darling Polly and dear son, Wilfred
vi
 vii

Foreword by Carrie
Newlands
Daniel is to be commended for his combination of enthusiasm, dedication
and artistic talent, which has given us this wonderful book. Anatomy is the
backbone of much of a surgeon’s working day; we need to have its intrica-
cies, vagaries, and three-​dimensional complexity at our fingertips in order
for us to do our jobs well and to deserve the trust our patients place in us.
Artistry and surgery go hand in hand and Daniel’s exquisite drawings in
this highly practical book make anatomy easy to understand with clarity and
elegance. Each picture paints a thousand words and thus, this first edition is
both detailed and portable.
The etymology of anatomical terms and the historical tit-​bits accom-
panying many anatomical eponyms serve to add another layer to the book’s
readability. Likewise, the inclusion of operative considerations bridges the
frequent gap between anatomical facts and surgical relevance.
A sound grounding in anatomy is still quite rightly required at under-
graduate level in medicine and dentistry and often serves to kindle an early
interest in many a future surgical career. I have no doubt that this addition
to the bookshelf will help many students to find head and neck anatomy less
of a terrifying prospect by sheer dint of its simplicity.
The Oxford Handbook of Head and Neck Anatomy will be particularly wel-
comed by those of us in head and neck surgical specialities at all stages of
our careers, and members of many medical specialities will find the artistry
and accessibility of this excellent resource to be invaluable.
Carrie Newlands
Consultant Oral and Maxillofacial Surgeon
Guildford, UK
Chair, UK OMFS FRCS Examination Board
vii
 ix

Foreword by Alice Roberts

If you want head and neck anatomy distilled down to its essence—​this is it.
The head and neck are so densely packed with anatomical structures, it’s
easy to get bogged down in unnecessary details while missing others that
are more clinically relevant. Written by an experienced clinician, this book
is laid out in a masterfully succinct and logical way, with clear, engineering-​
style diagrams that help the reader to conceptualize the three-​dimensional
jigsaw puzzle of head and neck anatomy. Along the way, there are nug-
gets of etymological delight that are historically fascinating—​but also make
the elaborate terminology more understandable and memorable. Covered
as well are those much beloved TLAs—​the three letter abbreviations that
litter the clinical landscape of anatomy.
This book will be useful to undergraduates learning anatomy for the first
time, but also for trainees specializing in those anatomical areas above the
clavicle—​who will look back and wish they’d had this text at medical school.
Armed with this powerful tome, the pterygopalatine fossa will never
again hold such terror, the infamous infratemporal fossa will be laid bare,
and the lacrimal lake of despond will dry up. And with this map in hand, a
safari in tiger country will be much, much less dangerous.
Professor Alice Roberts
Anatomist, author & broadcaster
Professor of Public Engagement in Science, University of Birmingham
x
 xi

Preface

One day I will find the right words and they will be simple.
Jack Kerouac

The idea for this book began while a medically qualified dental student,
embarking (again) on the seemingly Herculean task of learning head and
neck anatomy—​under the watchful eye and tutelage of Professor Susan
Standring. The book is aimed at medical and dental undergraduates facing
similar struggles—​as well as dentists, ENT, oral and maxillofacial or plastic
surgeons, anaesthetists, and radiologists with a particular interest in the
pathology of the head and neck.
The principle of the book is to provide a succinct yet comprehensive
pocket guide to the elegant and three-​dimensional anatomy of the head
and neck, accompanied by simple-​to-​use schematic line diagrams. It intends
to distil conceptually difficult regions of the head and neck into their re-
spective ‘bare bones’—​constructing a skeleton on which the flesh can be
subsequently added, in a format that can be reproduced (and hopefully
remembered) on the operating theatre whiteboard or in a notebook in the
outpatient clinic or ward environment.
Anatomy, like medicine, has a specific language. A language monopolized
by Latin. As with any language, understanding the meaning of a word helps
to glean its purpose—​and perhaps provide a glimpse into its etymological
or eponymous past. How can regional anatomy that includes references to
the winged helmet of Hermes, a goat, and a wandering vagrant not help but
spark inspiration and stimulate excitatory synapses?
The science of anatomy (from ἀνατομή meaning ‘to cut up’) underpins
pathology (‘the study of suffering’) which in turn provides the link to medi-
cine and its subsequent inquiry into disease. We are all anatomists at heart:
a strong foundation in anatomy promotes clinical ‘common sense’, acumen,
and surgical confidence—​allowing you to interpret the problem and to pro-
pose a solution on anatomical grounds.
My personal appreciation of the anatomy of the head and neck signifi-
cantly improved over the course of writing, researching and illustrating this
book. I have tried to balance bullet points and prose and to provide easy-​to-​
negotiate illustrations that are intended to simplify complicated anatomical
relationships. As a reader and ‘learner’, you will have your own areas of
difficulty and confusion and I welcome your suggestions as to how to im-
prove the text and figures.
Whether you are from a dental, medical, or surgical background, I hope
this book gives you the enthusiasm to continue to explore the anatomy,
surgery, and pathology that makes a career in a head and neck specialty so
rewarding.
Daniel R. van Gijn
xii
 xiii

Acknowledgement
Professor Patricia Collins
Chapter 15: Embryology of the head and neck
Professor of Anatomy, Anglo-European College of Chiropractic,
Bournemouth, UK

Miss Lisa Pitkin

Chapter 8: The Larynx
ENT and Head and Neck surgeon, Royal Surrey County Hospital, UK
xvi
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