Flashcards in H&N Deck (19)
Treatment for SCCa at the nasal sill or columella
WLE is better than radiation bc radiation may not penetrate well.
MCC of sinonasal CA
What nasal tumor has small round cells in rosettes?
Line from medial canthus to angle of mandible.
Tumors above spread superiorly and posteriorly
Tumors below carry better prognosis
Where do nose and sinus tumors met?
Cervical or retropharyngeal nodes
Why is radiation to the nose/paranasal sinuses controversial?
The associated morbidity to the eyes
Excluding skin cancer, what is the m/c H&N CA site?
Where does laryngeal CA occur?
Glottis (67%; 95% of which is TVC)
Why is it important to figure out which part of the larynx the cancer affects?
Each subsite has different drainage/spread, management, and prognosis
Supraglottis drains b/l to upper and middle jug LN
Glottis has no notable LN drainage but can invade pre-epiglottic space
What is the difference between radical, modified, and selective neck dissections?
-Radical: nodes, SCM, submandibular gland, tail of parotid, IJ, EJ, cervical sensory nerves, CN 11
-Modified: only nodes
-Selective: selective levels
What 2 structures are immediately deep to platysma?
How do you know when you are getting to the posterior limit of the neck dissection ( ie from IV into V)
Where greater auric turns around post belly of SCM
What node level for anterior oral cavity cancer?
I, II, III
What node level for cancer of OP, hypopharynx, or supraglottic?
II - IV
What node level for thyroid tumors?
II - IV, V
What node level for posterior scalp?
II - V and suboccipital nodes under trap posterior to V (posterior lateral neck dissection)
Classification of neck dissection
-Comprehensive: all nodes +/- other structures
-Selective: specific node levels
-Extended: posterior lateral, paratracheal
Most common site for H&N CA?
Oral cancer (30% of all H&N CA)