ENT Flashcards
(188 cards)
1
Q
Describe the external auditory canal:
A
About 2.5cm
Outer 1/3rd is cartilage with hairs and ceruminous (wax)
glands
Inner 2/3rd is bony and lined with sensitive skin
2
Q
What is chondrodermatitis nodularis helicis?
A
Tender cartilaginous inflammed nodule on helix due to pressure
3
Q
What is pinna haematoma?
A
Blunt trauma can cause bleeding in the subperichondrial plane elevating perichondrium to form a haematoma
4
Q
How should pinna haematoma be treated?
A
Incision of haematoma and primary closure
5
Q
What is the consequence of poor treatment of pinna haematoma?
A
Ischemic necrosis then fibrosis (cauliflower ear)
6
Q
What are auditory exostoses?
A
Smooth, multiple, bilateral swelling of bony canals that represent local bone hypertrophy from cold exposure
7
Q
What are the management options for excess ear wax?
A
Olive oil drops
Suction under direct vision using microscope
Syringing after softening with olive oil
8
Q
Describe the main features seen when examining the tympanic membrane:
A
Cone of light pointing to side of ear being examined Malleus and incus often seen Pars tensa (inferior drum) and pars flaccida (superior drum)
9
Q
What are some presenting features of otitis externa?
A
Discharge, itch, pain and tragal tenderness
10
Q
What are the main causative organisms of otitis externa?
A
Pseudomonas or S. aureus
11
Q
What are some predisposing factors to otitis externa?
A
Excess canal moisture, trauma, high humidity, absence of wax, narrow ear canal, hearing aids
12
Q
What is the treatment for mild-moderate otitis externa?
A
Clean EAC, topical Abx ± steroid drops
Keep ears water free
13
Q
What is the treatment for severe otitis externa?
A
Thin ear wick can be inserted with aluminium acetate
Once meatus opens up - microsuction or careful
cleansing
14
Q
How can the external auditory canal be cleaned?
A
Gentle syringing to remove debris, dry mopping with cotton wool under direct vision, microsuction
15
Q
What is furunculosis and what condition is it associated with?
A
Painful staph abscess arising in hair follicle within canal
Associated with diabetes
16
Q
How can malignant/necrotising otitis externa present?
A
Chronic ear discharge, deep severe otalgia, temporal headaches and sometimes CN palsies
17
Q
What are the consequences of malignant/necrotising otitis externa?
A
Temporal bone destruction and base of skull osteomyelitis
18
Q
What is the main causative organism of malignant/necrotising otitis externa and what condition is this disease associated with?
A
Pseudomonas
Diabetes
19
Q
What is the treatment for malignant/necrotising otitis externa?
A
Surgical debridement, systemic Abx, specific Ig
20
Q
What conditions can cause referred otalgia?
A
TMJ dysfunction
Ramsay-Hunt syndrome
Cervical spondylosis
Tonsillitis, quinsy
21
Q
What are the presenting features of acute otitis media?
A
Rapid onset of pain, fever, anorexia, vomiting
Bulging of TM causes pain and eases if drum perforates ± discharge
22
Q
What are some common organisms causing otitis media?
A
Pneumococcus, haemophilus, moraxella, streps + staph
23
Q
What is the management for otitis media, when would you give Abx?
A
Analgesia
Amoxicillin if: systemically unwell, immunocompromised, symptoms >4d, <3m, perforation
24
Q
What is chronic otitis media and what are some symptoms?
A
TM perforation in setting of recurrent or chronic infections
Hearing loss, otorrhoea, fullness, otalgia
25
What is the management for chronic otitis media?
Topical/systemic Abx, aural cleaning, water precautions
| May need myringoplasty/mastoidectomy
26
What is a complication of chronic otitis media?
Prolonged low middle ear pressure allows for retraction pocket of pars tensa/flaccida which can enlarge resulting in cholesteatoma
27
What is cholesteatoma and what are some symptoms?
Growth of squamous epithelium
| Foul discharge, hearing loss, headache, pain
28
What can be the complications of cholesteatoma?
Meningitis, cerebral abscess, hearing loss, mastoiditis
29
What is the treatment for cholesteatoma?
Mastoid surgery
30
What is mastoiditis?
Middle ear inflamm leads to destruction of air cells in mastoid bone ± abscess formation, can spread intracranially
31
What are some symptoms of mastoiditis?
Fever, tenderness, mastoid swelling and redness, protruding auricle
32
What is the management for mastoiditis?
CT imaging and admit for IV Abx, myringotomy ± mastoidectomy
33
What is myringoplasty?
Perforation in TM is patched using a graft (perichondrium/fascia) and applied underneath TM
Acts as scaffold for TM to grow across
34
What is mastoidectomy?
Mastoid surgery and tympanoplasty used to eradicate source of chronic infection/excise cholesteatoma
Removal of mastoid air cells
35
What are some presenting features of glue ear?
Poor speech, language delay, balance problems, poor progress at school
36
What are the management options for glue ear?
Actively observe for 3m
Autoinflation of Eustachian tube
Insertion of grommets
37
What does pure tone audiometry aim to measure?
Quantifies hearing loss and determines its nature
38
What does tympanometry aim to measure?
Measuring pressure in middle ear and establishing cause of conductive deafness
39
What hearing tests may be used in newborns?
Otoacoustic emissions
| Audiological brainstem responses
40
Describe the tympanogram seen if there is disruption of ossicles or if part of drum is flaccid:
Large peak (high compliance) when canal pressure = middle ear pressure
41
Describe the tympanogram if there is fluid in the middle ear:
Low flat result (low compliance) due to stiff ear drum
42
Describe the tympanogram seen in developing or resolving OM:
Shift in peak of curve to left found in negative middle ear pressure
43
How would you perform a Rinne's test?
Vibrating fork on mastoid to test BC
| When sound is no longer audible move in front of ear to test AC
44
What are the positive and negative results of Rinne's test?
Rinne’s +ve if AC > BC (normal or SNHL)
| Rinne’s -ve if BC > AC (CHL)
45
What are the possible results of Weber's test?
Equal = normal
Localised to side of HL if CHL
Localised away from side of HL if SNHL.
46
Define normal hearing, mild, moderate and severe hearing loss based on dBHL:
Normal hearing = -10-25dBHL with 0 as average
Mild HL = 26-40dBHL
Moderate = 41-70dBHL
Severe = 71-90dBHL
47
Describe the audiogram in presbycusis:
Bilateral, symmetrical, high freq SNHL
48
Describe the audiogram in noise-induced hearing loss:
Cahart’s notch at 4kHz with recovery at 8kHz
49
Describe the audiogram in conductive hearing loss:
Air-bone gap
50
Describe the audiogram in Meniere's disease:
Poor hearing a low frequencies in one ear, recovering at higher frequencies
51
What are some genetic causes of childhood deafness?
Congenital anomalies of pinna, EAC, drum or
ossicle
Treacher-Collins, Pierre-Robin
Alport’s, Turner’s
52
What are some non-genetic causes of childhood deafness?
Intrauterine TORCH infection (CMV, rubella, toxo, HSV, syphilis)
Prematurity, IVH, hypoxia
Meningitis, measles, mumps
53
What are the management options for childhood deafness?
Support + advice advice
Hearing aids or cochlear implants
Provide support to develop spoken or signed communication
54
Who are cochlear implants for?
Children and adults with profound SNHL who do not
| benefit from a conventional hearing aid
55
How do cochlear implants work?
Multichannel electrode inserted surgically into cochlea that directly stimulates the auditory nerve when electrical signals are applied
56
When are bone-anchored hearing aids used?
Intolerance to conventional hearing aid, congenital malformations, single sided deafness
57
How do bone-anchored hearing aids work?
Sound is transmitted to cochlea via bone conduction,
| titanium screw implanted into bone and attached to hearing aid
58
What are some causes of conductive hearing loss in adults?
External canal obstruction: wax, pus, debris, FB
Drum perforation: trauma, barotrauma, infection
Otosclerosis
59
What are some causes of sensorineural hearing loss in adults?
Acoustic neuroma, cholesteatoma
Ototoxic drugs
Post-infective: meningitis, measles, herpes, syphilis
Meniere’s, trauma, presbycusis
60
What are some drugs that can cause of sensorineural hearing loss?
Vancomycin, gentamicin, chloroquine, vinca alkaloids
61
What are some causes of sudden hearing loss?
Conductive infection, occlusion, trauma, fracture
| If SN: noise exposure, gent toxicity, acoustic neuroma, MS
62
How should sudden hearing loss be investigated?
EAC and TM examination, tuning forks
FBC, CRP, U+E, LFT, TSH, clotting, glucose
Audiometry, MRI
63
What is otosclerosis?
New bone is formed around stapes footplate, leads to fixation and CHL
64
What is the inheritance pattern of otosclerosis?
Autosomal dominant
65
What are the features of otosclerosis?
Early adult life, accelerated by pregnancy, conductive deafness, tinnitus, transient vertigo, pink tinge to drum (Schwartze’s)
66
What is the treatment for otosclerosis?
Hearing aid, surgery (stapedectomy/stapedotomy)
67
What is presbycusis?
Age-related, bilateral, high freq SNHL
| Deafness (loss of hair cells) is gradual
68
Describe how the cochlea is involved in the perception of sound:
Stapes articulates with oval window causing movement of perilymph and pressure change
Vibrations transmitted through endolymph to tectorial membrane and movement of this causes movement of hair cells resulting in depolarisation and perception of sound
69
What is tinnitus?
Perception of sound, typically in absence of auditory stimulation
70
What can cause objective tinnitus?
AV malformations, Paget’s, hyperthyroidism, anaemia
71
What can cause subjective tinnitus?
Presbycusis, noise induced HL, Meniere’s, wax, ototoxic drugs, OM, AN, trauma, mental health issues
72
What drugs can cause tinnitus?
Cisplatin + aminoglycosides
| Aspirin, NSAIDs, quinine, macrolides, loop diuretics
73
How should tinnitus be investigated?
Audiometry, tympanogram, unilateral may need MRI to exclude AN
74
What are some management options for tinnitus?
Treat cause
Explain tinnitus often improves with time
Hearing aids, sound therapy, CBT, pt support groups, hypnotics
75
What is an acoustic neuroma?
Vestibular schwannomas, usually arising on superior vestibular nerve Schwann cell layer
76
What are some presenting features of acoustic neuroma?
Progressive ipsilateral tinnitus ± SNHL
| If large, ipsilateral cerebellar signs, RICP, numb face
77
How might acoustic neuroma be investigated and managed?
MRI
| Watch and wait, surgery, radiosurgery
78
What are some symptoms of noise induced hearing loss?
Bilateral symmetrical SNHL, tinnitus, hearing improves away from source of exposure
79
What is the management for noise induced hearing loss?
Reduce risk of occupational exposure – ear defenders, screening of at risk
Hearing aids
80
What is vertigo?
Sensation that you, or the world around you, is moving or spinning
81
What are some causes of peripheral vertigo?
Meniere’s, BPPV, vestibular failure, labyrinthitis
82
How should vertigo be investigated?
CNs and ear examination, cerebellar function, reflexes,
| Romberg’s, head thrust test, Hallpike test
83
What are some causes of central vertigo?
AN, MS, head injury, migraine associated dizziness, vertebrobasilar insufficiency, stroke
84
Describe benign paroxysmal positional vertigo:
Attacks of sudden rotational vertigo lasting >30sec, provoked by head-turning
85
What is the cause of benign paroxysmal positional vertigo?
Displacement of otoconia stimulating semi-circular canals
86
How is BPPV diagnosed?
Dix-Hallpike +ve
| No persistent vertigo; no tinnitus, headache, ataxia,
87
How is BPPV treated?
Often self-limiting
| If persistent: Epley manoeuvre, home repositioning manoeuvres
88
Describe the Dix-Hallpike test:
Ask pt to keep eyes open and look straight ahead
With pt sitting on coach, turn head 45° towards test ear Continue to hold head between hands and ask them to lie backwards then quickly lower head 30° below level of couch
Ask if they feel dizzy and look for nystagmus
If +ve, there is vertigo and rotary nystagmus towards undermost ear, lasting 30sec
89
Describe the Epley manoeuvre:
Move pt head through 4 sequential positions, resting for 30sec between movements
Aim is to reposition otoconia away from sensitive posterior canals
90
Describe the features of Meniere's disease:
Sudden attacks of vertigo lasting 2-4h with nystagmus May be increasing fullness in ears ± tinnitus followed by vertigo
Symptoms often become bilateral and fluctuating SNHL common
91
What is the management for Meniere's? (include acute, prophylactic + persistent)
Low-salt diet
Acute: prochlorperazine
Prophylaxis: betahistine, thiazides.
If persistent, instillation of gentamicin via grommets, labyrinthectomy, vestibular neurectomy, vestibular destruction with gent injection
92
What are the features of vestibular neuronitis/labyrinthitis?
Sudden attacks of unilateral vertigo and vomiting in previously well person, often following recent URTI
Lasts 1-2d
Hearing loss in labyrinthitis
93
What is the treatment for vestibular neuronitis/labyrinthitis?
Vestibular suppressants - prochlorperazine, cyclizine
94
What is vestibular migraine?
Migraine variant, characterised by a combination of vertigo, dizziness, or balance disturbance with migrainous features
95
What is acute rhinosinusitis and how is it managed?
Common cold and most episodes are self-limiting
| If symptoms persist >5d, consider intranasal corticosteroids
96
What is chronic rhinosinusitis and how is it managed?
>12w
| Intranasal corticosteroids and nasal saline irrigation
97
If a single unilateral nasal polyp is found, what investigation should be carried out?
Biopsy
98
What conditions are nasal polyps associated with?
Allergic + non-allergic rhinitis, CF, asthma,
| septal deviation, immunosuppression, aspirin hypersensitivity, pregnancy
99
What are some symptoms of nasal polyps?
Watery anterior rhinorrhoea, sneezing, purulent postnasal drip, nasal obstruction, sinusitis, mouth-breathing, snoring, headaches
100
How can nasal polyps be investigated?
Anterior rhinoscopy or nasal endoscopy, CT
101
How can nasal polyps be differentiated from turbinates?
Polyps pale, mobile and insensitive to gentle palpation
| Turbinates pink, mobile and sensate
102
What are the management options for nasal polyps?
Topical steroid drops shrink polyps
Long term Abx (doxycycline)
Endoscopic sinus surgery, polypectomy
103
How should allergic rhinosinusitis be investigated?
Skin prick testing/RAST
104
What are some symptoms of allergic rhinosinusitis?
Sneezing, pruritus, nasal discharge, bilateral itchy red eyes, swollen turbinates, pale mucosa, may be nasal polyps
105
How can allergic rhinosinusitis be managed?
Allergen avoidance, nasal saline irrigation, antihistamines, intranasal corticosteroids sprays
106
What are some features associated with acute bacterial sinusitis?
Discoloured discharge, purulent secretions,
| severe local pain (unilateral), fever, elevated CRP
107
What are some common causative organisms of acute bacterial sinusitis?
S. pneumoniae, H. influenzae, S. aureus, Moraxella, fungi
108
How should acute bacterial sinusitis be managed?
Amoxicillin
| Analgesia, nasal saline irrigation, intranasal decongestants
109
How should recurrent sinusitis be investigated?
CT paranasal sinuses and nasal endoscopy
110
Which sinuses drain into the middle meatus?
Maxillary
Anterior + middle ethmoidal
Frontal
111
Which sinus drains into superior meatus?
Posterior ethmoidal
112
Where does the sphenoid sinus drain into?
Spheno-ethmoidal recess
113
Where does the naso-lacrimal duct drain into?
Inferior meatus
114
What are some complications of sinusitis?
Orbital cellulitis/abscess, meningitis, encephalitis, cerebral abscess, cavernous sinus thrombosis
115
How can nasal fractures present?
New nasal deformity, facial swelling, black eyes, may have septal haematoma
116
How should nasal fractures be managed?
Treat epistaxis, analgesia, ice, close injuries
| Reassess 5-7d after and MUA can be performed 10-14d after
117
What can cause septal perforation?
Septal surgery, trauma, inhalants (sprays, cocaine), TB, SCC
118
How should septal perforation be managed?
Saline nasal irrigation, petroleum jelly, surgical repair
119
How can nasopharyngeal cancer present?
Cervical lymphadenopathy, unilateral hearing loss, nasal bleeding/obstruction/discharge, CN palsies
120
What is a septoplasty?
Corrects deviated nasal septum
121
What is a septorhinoplasty?
Aims to straighten and/or refashion shape of nose
122
What is nasal saline irrigation?
Pts sniff saline solution into nostril, removes debris and prevents crusts from forming after surgery or epistaxis, clears irritant allergens
123
What are some causes of epistaxis?
Idiopathic, local trauma (nose picking), facial trauma, dry/cold weather, haemophilia, vasculopathies, septal perforation
124
Describe the management steps for epistaxis:
Pinch lower part of nose for 20min, sit forward
Silver nitrate cautery of bleeding points
If bleeding continues: anterior nasal pack
If still bleeding, postnasal pack – Foley catheter to occlude posterior choana
Arterial ligation/embolisation
125
What is Little's area (Kiesselbach’s plexus)?
Where anterior ethmoidal, sphenopalatine and facial arteries anastomose
126
What is the name of the site where pharyngeal pouches can form?
Killian’s dehiscence
| Between inferior constrictor and cricopharyngeus is area deficient of muscle
127
What are the common organisms that cause tonsillitis? (virus + bacteria)
Rhinovirus, parainfluenza virus, influenza, adenovirus, EBV
| Group A beta-haemolytic strep (S. pyogenes), staph, S. pneumoniae
128
How should tonsillitis be managed?
Reassurance, regular ibuprofen ± paracetamol
| If Centor criteria 3 or 4, consider pen V for 10d
129
Describe the Centor criteria:
Presence of tonsillar exudate, presence of tender anterior cervical lymphadenopathy, fever, absence of cough
Presence of 3/4 suggest Strep infection
130
What are some complications of tonsillits?
Otitis media, sinusitis
Peritonsillar abscess (quinsy)
Parapharyngeal abscess
Lemierre syndrome
131
What are some symptoms of quinsy?
Sore throat, dysphagia, peritonsillar bulge, uvular deviation, trismus, muffled voice
132
How should quinsy be managed?
IV Abx and aspiration needed
133
What is Lemierre syndrome?
Acute sepsis and jugular vein thrombosis secondary to infection with Fusobacterium + septic emboli
134
What are the indications for tonsillectomy?
Recurrent tonsillitis where episodes of sore throat are disabling
≥7 sore throats in preceding year, ≥5 in each of last 2y, ≥3 in each of last 3y
135
What are the complications of tonsillectomy?
Primary haemorrhage (<24h) – return to theatre Secondary haemorrhage (typically after 5-10d) due to infection of tonsillar fossae
136
What is the cause of scarlet fever?
Exotoxins released by S. pyogenes
137
What are some symptoms of scarlet fever?
Red ‘pin-prick’ blanching rash develops on chest, axilla and behind ears after initial sore throat + fever
Strawberry tongue and facial flushing
138
What is the treatment for scarlet fever?
Pen V for 10d
139
What is stridor?
High-pitched noise heard in inspiration from partial obstruction at larynx or large airways
140
What are some causes of stridor?
Laryngomalacia, laryngitis, epiglottitis, croup, anaphylaxis
141
What can cause dysphonia?
Laryngeal cancer
Vocal cord palsy and nodules
Laryngitis + reflux laryngitis
Reinke’s oedema
142
What are the features of recurrent laryngeal nerve palsy?
Weak, breathy voice, weak cough, repeated coughing, aspiration, exertional dyspnoea
143
What are the causes of recurrent laryngeal nerve palsy?
Cancer, iatrogenic (parathyroidectomy, oesophageal/pharyngeal pouch surgery), syringomyelia, TB, aortic aneurysm, idiopathic
144
What investigations should be performed if recurrent laryngeal nerve palsy is suspected?
CXR, CT, US thyroid, laryngoscopy
145
What are some malignant causes of dysphagia?
Oesophageal, pharyngeal, gastric, extrinsic pressure e.g. lung Ca, node enlargement
146
What are some neurological causes of dysphagia?
Bulbar palsy, lateral medullary syndrome, MG, syringomyelia
147
What are some other causes of dysphagia (not malignant/neuro)?
Benign strictures, pharyngeal pouch, achalasia, oesophagitis
148
How should dysphagia be investigated?
FBC, CRP, CXR, barium swallow, endoscopy + biopsy
149
What are some features of pharyngeal pouch?
Dysphagia with gurgling, regurgitation of undigested food, halitosis, lump in neck, aspiration
150
How should pharyngeal pouch be treated?
Endoscopic sampling of wall that divides pouch from oesophagus
151
What is globus pharyngeus/hystericus?
Sensation of lump in throat most noticed when
| swallowing saliva, can be due to stress/anxiety
152
What are some symptoms associated with H+N SCC?
Neck pain, lump, hoarse voice (>6w), sore throat (>6w), painless ulcers
153
How should H+N SCC be investigated?
Panendoscopy, FNA/biopsy of masses, CT/MRI
| neck
154
Describe the course of the facial nerve?
Arises in medulla and emerges between pons and medulla, travels through posterior fossa and runs through middle ear before emerging from
stylomastoid foramen to pass into parotid
155
What are some intracranial causes of facial nerve palsy?
Brainstem tumour, stroke, MS, acoustic neuroma, meningitis
156
What are some intratemporal causes of facial nerve palsy?
OM, RH syndrome, cholesteatoma
157
What are some infratemporal causes of facial nerve palsy?
Parotid tumour, trauma
158
How should neck lumps be investigated?
Neck examination, endoscopy, US, FNA cytology, biopsy, CT, virology
159
What can be the cause of midline neck lumps?
Dermoid cysts, thyroglossal cysts, thyroid mass (goitre)
160
What are the borders of the submandibular triangle?
Bordered above by mandible and below by digastric
161
What can be the cause of lumps within the submandibular triangle?
Reactive or malignant lymphadenopathy, salivary stone
162
What are the borders of the anterior triangle?
Between midline, anterior border of SCM and mandible
163
What can be the cause of lumps within the anterior triangle?
Lymphadenopathy, branchial cysts, parotid tumour, laryngoceles, carotid artery aneurysm
164
What are the borders of the posterior triangle?
Posterior border of SCM, anterior edge of trapezius, clavicle
165
What can be the cause of lumps within the posterior triangle?
Cervical ribs, pharyngeal pouches, cystic hygromas,
| lymphadenopathy
166
Where do retropharyngeal abscesses form?
Anterior to prevertebral fascia and behind pharynx
| Extends from base of skull to mediastinum
167
What are some symptoms of retropharyngeal abscesses?
Rigid neck, reluctance to move, systemically unwell, dysphagia, odynophagia
168
How should retropharyngeal abcesses be managed?
Secure airway, IV Abx, incision and drainage
169
What is Ludwig's angina?
Infection of space between floor of mouth and mylohyoid
170
What are some symptoms of Ludwig's angina?
Swelling of floor of mouth, painful mouth, protruding tongue, airway compromise, drooling
171
How should Ludwig's angina be managed?
Secure airway, IV Abx, surgery to drain collection
172
What are the commonest causes of obstructive sleep apnoea in adults and children?
In children, adenotonsillar hypertrophy
| In adults, obesity
173
How should obstructive sleep apnoea be investigated?
BMI, TFT, CXR, ECG, sleep study, Epworth score
174
What is the management for obstructive sleep apnoea?
Weight loss, CPAP, surgery in children (adenotonsillectomy)
175
What are the main types of thyroid neoplasms?
```
Benign adenoma – mainly follicular
Papillary adenocarcinoma – 70%
Follicular adenocarcinoma – 20%
Medullary carcinoma – 5%
Anaplastic carcinoma – 5%
```
176
How should thyroid neoplasms be managed?
Adenomas require no further treatment after diagnostic hemithyroidectomy
Carcinoma: total thyroidectomy + adjuvant radio-iodine if papillary and follicular
177
What are the complications of thyroidectomy?
Post-op haemorrhage
Airway obstruction
Vocal cord palsy
Hypocalcemia
178
What is sialadenitis?
Acute infection of submandibular or parotid glands
179
How should sialadenitis be managed?
Abx, good oral hygiene, sialogogues, may need surgical drainage
180
How can sialolithiasis present and which gland is usually affected?
Pain and tense swelling of gland during/after meals
| Submandibular gland
181
What is Sjogren's syndrome?
Autoimmune, lymphocytic infiltration into ductal tissue of secretory glands
182
How can Sjogren's present?
Dry eyes, dry mouth, enlarged salivary glands
183
What can cause xerostomia?
Hypnotics, tricyclics, antipsychotics, beta blockers, diuretics
Dehydration, ENT RT, Sjogren’s, SLE, sarcoid, HIV, parotid stones
184
How should xerostomia be managed?
Increase oral fluids, good dental hygiene, saliva substitutes
185
In which gland are the majority of salivary gland tumours found?
80% in parotid
186
What are some symptoms of salivary gland tumours?
Hard fixed mass, pain, overlying skin ulceration, lymphadenopathy
187
What investigations can be performed if suspected salivary gland tumour?
US, MRI, FNA cytology/CT guided biopsy, X-ray, sialography
188
How should salivary gland tumours be managed?
Surgery, RT
