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Head and Neck > Head and Neck Surgery > Flashcards

Head and Neck Surgery Flashcards

(49 cards)

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1
Q

Describe Branchial cysts

A

Congenital epithelial cysts, occurring laterally due to failure of obliteration of the 2nd branchial cleft in embryonic development

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2
Q

Describe Cystic hygromas

A

Cystic lymphatic lesion that occurs in the POSTERIOR triangle of the neck. Most present at birth or before 2 years. (They are transillumable)

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3
Q

Where do branchial cysts typically form

A

Anterior to the SCM near the angle of the mandible

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4
Q

How does branchial cyst appear on echo

A

Anechoic

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5
Q

Describe dermoid cysts

A
  • Derived from pleuripotent stem cells and are located in the midline
  • Usually in a suprahyoid location
  • Contain variable amounts of calcium and fat
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6
Q

Describe a ranula

A

Mucocele in the floor of the mouth originating from the sublingual glands

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7
Q

How are ranulas treated

A

Surgical excision inclusive of the sublingual glands

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8
Q

Describe a Laryngocele

A

Air pocket that arises from the deepest point of the laryngeal ventricle that can bulge internally into the larynx

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9
Q

Describe Pharyngeal pouch

A

Posteromedial herniation between thyropharyngeus and cricopharyngeus muscles - Killian’s dehiscence (acquired diverticulum)

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10
Q

How are pharyngeal pouches classified

A

Lahey classification:

  • Type 1 = small mucosal protrusion
  • Type 2 = definite pouch
  • Type 3 = large pouch (oesophagus is pushed forwards)
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11
Q

Distribution of salivary stone disease

A
  • 80-90% Submandibular

- 10-20% Parotid

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12
Q

Risk factors for salivary stone disease

A
  • Dehydration
  • Gout
  • Diabetes
  • HTN
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13
Q

Composition of salivary gland stones

A
  • Calcium phosphate

- Calcium carbonate

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14
Q

GOLD standard investigation for salivary gland stones

A

Sialography (contraindicated in those with iodine allergy)

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15
Q

Describe the management of salivary stone disease

A

Gland excision, unless distally sited and mobile in Wharton’s duct in which case endoscopy can be attempted

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16
Q

What typically causes Sialadenitis

A

Staphylococcus aureus

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17
Q

What complicates Sialedentiis

A

Development of a submandibular abscess may spread through the deep fascial spaces and occlude the airway

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18
Q

Most common submandibular gland tumour

A

Adenoid cystic carcinoma

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19
Q

How are submandibular tumours diagnosed

A

FNAC

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20
Q

What is the most common parotid neoplasm

Study These Flashcards
A

Benign pleomorphic adenoma (benign mixed tumour)

21
Q

Describe a Warthin tumour

Study These Flashcards
A
  • Most common bilateral benign neoplasm of the parotid
  • Lymphocytic infiltrate and cystic epithelial proliferation
  • Associated with smoking
22
Q

Describe parotid Haemangioma

Study These Flashcards
A
  • Consider with parotid mass in a child (accounts for 90%)

- Hypervascular on imaging

23
Q

Most common type of oral cancer

24
Q

Risk factors for oral SCC

Study These Flashcards
A
  • Smoking and alcohol
  • Betel nut
  • Leukoplakia
  • Dental caries
  • Chronic glossitis
  • Malnutrition
  • Cirrhosis
  • HIV
25
How are oral cavity tumours investigated
- EUA and biopsy - Panendoscopy - Plain x-ray - CT to assess nodal status
26
Management of T1 and T2 <3cm oral tumours
Surgery OR Radiotherapy
27
Management of large volume T2, T3 and T4 oral tumours
- Surgery | - Adjuvant radiotherapy
28
How is lymph node disease managed in oral cancer
Modified radical or extended neck dissection
29
Risk factors for oropharyngeal SCC
- Smoking - Alcohol - Betel nut and tobacco chewing - Dental sepsis - Ionising radiation - HPV 8 and 16 - Submucosal fibrosis of the palatine arch
30
How are oropharyngeal tumours investigated
- FNAC - Panendoscopy and bilateral tonsillectomy - CT neck and chest - Liver USS
31
Outline the management for base of tongue cancerous lesions
- T1 = radical radiotherapy - T2-4 = chemoradiotherapy or resection with free flap reconstruction and bilateral neck dissection with postoperative radiotherapy
32
Outline the management of tonsillar cancerous lesions
- T1-2 = transoral surgery or radical radiotherapy - T3-4 = radical resection with neck dissection and reconstruction (pectoralis flap or free radial flap, fibular flap if section of mandible is removed)
33
Define level 1 lymph nodes in the neck
Submental and submandibular
34
Define level 2 lymph nodes in the neck
Upper jugular from skull base to hyoid
35
Define level 3 lymph nodes in the neck
Middle jugular from the hyoid to the cricoid cartilage
36
Define level 4 lymph nodes in the neck
Lower jugular from cricoid to clavicle
37
Define level 5 lymph nodes in the neck
Posterior triangle
38
Define level 6 lymph nodes in the neck
Anterior compartment nodes from the hyoid bone to the suprasternal notch, bounded laterally by the medial border of the carotid sheath
39
Define level 7 lymph nodes in the neck
Nodes in the superior mediastinum
40
How do nasopharyngeal tumours typically present
- Epistaxis - Nasal obstruction - Neck lump - Otalgia - Otitis media with effusion
41
Risk factors for nasopharyngeal tumours
- HLA-A2 gene - Positive family history - EBV infection - Salt-preserved fish (nitrosamines) - Vitamin C deficiency - Male predominance
42
How are nasopharyngeal tumours managed
Curative radiotherapy (surgery has no place)
43
Origin of pleomorphic adenomas
Myoepithelial cells and intercalated duct cells
44
How is benign parotid disease such as pleomorphic adenoma treated
Superficial parotidectomy
45
What parotid tumour typically invades the facial nerve
Adenoid cystic carcinoma
46
Why may otalgia develop following tonisllectomy
Referred along glossopharyngeal nerve
47
What drugs are associated with parotid gland enlargement
Thiouracil, isoprenaline, phenylbutazone, COCP
48
Cellular contents of pleomorphic adenoma
Epithelial and stromal elements
49
How are salivary gland tumours investigated
- MRI to delineate nerve involvement | - FNAC

Head and Neck (7 decks)

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