Lecture 2- Surgical management of Head and Neck lumps

Question 1

Stages to go through when examining a H and N lump?

Answer 1

History
Local exam
Regional exam
general exam
Provisional diagnosis
Special tests
Tipping point- Refer or not?

Question 2

Which special tests would you use?

Answer 2

Bloods- (FBC, U+E,LFT,specific antibodies, thyroid function)
Radiology-( MRI, Ultrasounds, CT, sialography, Isotope, PET, Plain)
Microbiology- Take a swab or biopsy

Question 3

What are the 5 possible congenital reasons for H+N lumps?

Answer 3

Lymphangioma
Dermoid cysts
Thyroglossal cysts
Branchial cycst
Pharyngeal pouch.

Question 4

What are the 8 acquired reasons for a lump?

Answer 4

Trauma
Infective
Inflammatory
Iatrogenic
Neoplastic
Metabolic
Autoimmune

Question 5

List three trauma scenarios that could lead to a lump?

Answer 5

Haematoma
Dissection
Air emphysema

Question 6

What infective reasons could there be for a lump?

Answer 6

Dental infection
Neck space infection
EBV
Cat scratch disease
Toxoplasma
TB
CMV
HIV

Question 7

What are the inflammatory causes of a lump?

Answer 7

Sialodenitis
Sarcoidosis
Rheumatoid

Question 8

Metabolic causes?

Answer 8

Related to tumour on endocrine organs

Question 9

What are the red flags for H+N Lumps?

Answer 9

Rapid growth
effect on adjacent structures ( Nerves, airway)
Rosk factors (Age, smoking, FH)
Systemic features e.g weightloss