head and neck -- upper airways, nasal, sinuses, neck Flashcards
(37 cards)
What are the two types of odontogenic cysts and what do they come from?
Developmental (dentigerous most common subtype) and Inflammatory (radicular aka ‘periapical’ most common subtype).
Inflammatory is more common overall and both types of cysts come from odontogenic epithelium
What is the name for a malignant tumor of odontogenic origin?
ameloblastoma
What conditions lead to a tumor or bump in the nose/nasal cavity/nasal pharynx?
polyps (not really a tumor but most common) angifibroma papilloma plasmacytoma neuroblastoma nasopharyngeal carcinoma
Most nasal polyps generally result from what?
allergic rxn
What is the best way to view the sinuses?
limited CT scan
How is allergic rhinitis mediated?
IgE with lots of esinophils
How does allergic rhinitis present?
mucosal erythema and edema. lots of mucus secretion.
turbinates pale.
why does chronic allergic rhinitis sometimes get biopsied?
thickness of mucosa builds up such that it can be mistaken for a bacterial infx
What is the most common cause of infectious rhinitis?
Virus…adenovirus most often. Also rhinovirus.
How does infectious rhinitis present?
edematous, erythematous, thickened nasal mucosa. turbinates are enlarged.
also may see concomitant pharyngotonsilitis because viruses spread everywhere at once.
What is the usual origin of chronic rhinitis?
repeat acute rhinitis (allergic or infectious) with secondary microbial infx.
deviated septum and nasal polyps predispose.
how does chronic rhinitis often present?
grey hue to the mucosa and not nearly as much edema. often ulceration of the mucosa. risk of spreading suppurative infx to the sinuses.
What are nasal polyps? What do they arise from? What is often present in their infiltrate? And what must be ruled out when they appear in a young caucasian?
edematous mucosa with loose stroma. come from recurrent rhinitis or an unknown origin. infiltrate has inflammatory eosinophils and PMNs. must rule out CF in a young caucasian.
what cells are common in the infiltrate of chronic rhinitis and polyps?
inflammatory cells….PMNs, eosinophils
What are the sxs of Samter’s triad?
chronic rhinosinusitis w/ polyps
severe asthma
salicylate sensitivity
reaction to aspirin but also can be NSAIDs
what dzs are associated with nasal polyps?
- samter’s triad
- CF
- allergic fungal sinusitis
- kartagener’s syndrome
- young’s syndrome
What are the top three problems leading to acute sinusitis?
- Drainage is uphill for maxillary sinus
- Sinuses are bony caves making it hard for Abx to even get in there
- Pseudmonas has figured out how to not get killed even if drugs reach it
What are common precursors to acute rhinosinusitis?
acute or chronic rhinitis
______ account for 90-95% on infectious sinusitis cases
viruses
What are the three categories of sinusitis based on time?
Acute: sxs for less than 4 wks
Subacute: sxs for 4-12 wks
Chronic: sxs for 12+ wks
__________ patients and those with ________ are more prone to a fungal sinusitis (mucormycosis).
immunocompromised;
diabetes (fungi love the high blood sugar)
Where are some dangerous and nearby places sinus infxs like to spread?
the eye (opthalmitis) soft tissue around the eye (periorbital cellulitis) facial bone (osteomyelitis) cranial vault (meningitis; encephalitis)
What is Kartagener syndrome and how does it present?
autosomal recessive d/o where the cilia don’t move (ciliary dyskinesia).
presents as: chronic sinusitis, bronchiectasis, situs inversus
What are the two ‘necrotizing’ upper airway lesions? How serious are they?
‘lethal’ midline granuloma: a tumor of NKT cells
‘wegener’ granulomatosis: causes necrotizing gingival ulcerations
both are potentially fatal as necrotization opens the way for bacterial infx.
NK cell lymphoma is radiosensitive but spreads everywhere and so you can’t radiate the whole body at once.
