An understanding of anatomy is paramount to the ability to safely anesthetize the head and neck surgery patient. The basic underlying structure of the face is formed by the skull, facial bones and mandible. The cochlear hair cells activate the cochlear nerve, resulting in hearing transmission. The labyrinthine and tympanic portions of the facial nerve lie in close proximity to these structures and may be dehiscent, necessitating lack of neuromuscular blockade and close monitoring of facial movements during certain otologic procedures. The nose projects from the face largely based on the amount of cartilage. The oral cavity therefore includes the lips, buccal mucosa, maxillary and mandibular alveolar ridges/teeth/gingiva, floor of the mouth, hard palate, the retromolar trigone and the anterior oral tongue. Neck anatomy can be significantly altered by cancer or cancer treatments including surgery and radiation or chemoradiation therapy.