Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

xD3 Oral Surgery Ex2 > Salivary Gland Disease (Deluke) > Flashcards

Salivary Gland Disease (Deluke) Flashcards

(94 cards)

Start Studying
1
Q

What are 3 major categories of salivary gland pathology?

A
  1. Cystic-like
  2. Inflammatory
  3. Tumors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the most common categories of salivary gland pathology?

A
  1. Cystic-like

2. Inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a cystic like lesion of the minor salivary glands, common in young males, often due to trauma?

A

Mucocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a cystic like lesion of the sublingual gland, (a mucocele on the floor of the mouth)?

A

Ranula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the difference between a Ranula and a Plunging Ranula ?

A
  1. Ranula is in the floor of the mouth and above the mylohyoid
  2. Plunging ranula is in the neck and below the mylohyoid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are 3 cytsic lesions found in the Parotid ?

A
  1. Parotid duct cyst
  2. Retention cyst
  3. Lymphoepithelial cyst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Of the 3 cystic lesions of the Parotid, which one is bilateral and common in pts with HIV: parotid duct cyst, retention cyst, or lymph epithelial cyst?

A

Lymphoepithelial cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When pt complains of decreased saliva production or decreased saliva flow, what salivary gland pathology should be considered first: cystic like, inflammatory, or tumor?

A

Inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are causes of inflammatory salivary gland lesion?

A
  1. Primary infection
  2. Autoimmune disease
  3. Sialadenosis
  4. Possibly a retrograde infection
  5. Stones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which gland produces the most saliva as well as being prone to the most stones as it is tortuous, gravity is pulling on it, and its secretions have a higher mineral content?

A

Submandibular gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is an idiopathic inflammatory salivary gland lesion that is common in teenagers and will not usually have an obstruction, e.g. a stone?

A

Sialadenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are 3 delineations to make when diagnosing an inflammatory disease?

A
  1. Acute vs chronic
  2. Suppurative vs nonsuppurative
  3. Adult vs juvenile
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is most commonly used X-ray to detect for salivary gland stones, now moving to CBCT?

A

Occlusal radiograph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Whenever one stone is seen on an image, what should you look for?

A

Another salivary duct stone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a common cause of decreased salivary duct flow?

A

Sialothiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A sialolith in the submandibular gland will be radiopaque or radiolucent?

A

Radiopaque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

A sialolith in the Parotid gland will be radiopaque or radiolucent?

A

Radiolucent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which is a more common sialolith location: submandibular gland or parotid?

A

Submandibular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a rare cause of decreased slivery flow?

A

Congenital ductal malformation e.g. juvenile chronic recurrent parotitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If a submandibular gland sialolith is distal to the mylohyoid(if it is away from the gland), is it retrievable or does it require gland removal?

A

Retrievable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

If a submandibular gland sialolith is proximal to the mylohyoid (if it is close to the gland), is it retrievable or does it require gland removal?

A

Requires gland removal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

If a parotid sialolith is proximal to the duct (close to the gland) is the stone retrievable or is gland removal indicated?

A

Gland removal indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

For a parotid sialolith proximal to the gland indicating gland removal, must the entire parotid be removed?

A

No, normally just the superficial lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the landmark for the parotid gland?

A

Masseter muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are 3 causes of decreased saliva production (note this is not decreased salive flow)?
1. Malnutrition 2. Alcoholism 3. Long-term dehydration (as with a surgery patient)
26
What its the most common bacterial cause of salivary gland infection?
Staphylococcus
27
What is the most common viral cause of bilateral parotid swelling?
Mumps
28
Coxsackie and CMV infections in the salivary glands are commonly seen in what patient type?
Immunosuppressed
29
What are 3 autoimmune syndromes that can affect salivary glands?
1. Sjogren’s or Sicca syndrome 2. Sarcoidosis 3. Heerfordt’s syndrome
30
Having Sjogren’s syndrome increases a pt’s risk for what cancer?
Non-hodgkin's lymphoma
31
What is the most common place to biopsy for sarcoidosis?
Labial biopsy (inside of lower lip)
32
Sarcoidosis is a multisystem granulomatous disorder of unknown cause. What clinical syndrome associated with acute sarcoidosis involves the patient presenting with parotid enlargement, anterior uveitis of the eye, facial paralysis, and fever?
Heerfordt's syndrome
33
What is the most common salivary gland to have a neoplasm?
Parotid
34
n general, how does the prognosis of a salivary gland neoplasm go based on location in the mouth?
Prognosis decreases as get lower in the mouth and more minor glands
35
What percentage of parotid neoplasms are benign?
80%
36
What percent of submandibular gland neoplasms are benign?
20%
37
What percent of sublingual / minor salivary gland neoplasms are benign?
40%
38
What are 2 theories of neoplasm etiology?
1. Bicellular | 2. Multicellular
39
What is the general idea for the bicellular theory of salivary gland neoplasm etiology?
Breaks gland into 2 sections and determines which of the 2 areas is contributing cells
40
In the multicellular theory of salivary gland neoplasm etiology, what neoplasm arises from striated ducts?
Oncocytic tumors
41
In the multicellular theory of salivary gland neoplasm etiology, what neoplasm arises from acinar cells?
Acinic cell carcinoma
42
In the multicellular theory of salivary gland neoplasm etiology, what neoplasm arises from excretory ducts?
Squamous cell and mucoepidermoid carcinoma
43
In the multicellular theory of salivary gland neoplasm etiology, what neoplasm arises from intercalated duct and myoepithelial cells?
Pleomorphic tumors
44
Is xerostomia a common complaint with salivary gland tumors?
No, because contralateral gland will still contribute saliva
45
What imaging is the gold standard for salivary gland tumor diagnosis?
CT scan and MRI
46
What is the name of the procedure in which a thin hollow needle is inserted into a mass for sampling cells, then immediately examined under a microscope?
Fine Needle Aspiration (FNA)
47
What is a limitation with the FNA (fine needle aspiration)?
Can only tell if malignant or benign, not what type of tumor it is
48
What is indicated if a salivary gland tumor is determined malignant at FNA?
Biopsy and plan further treatment accordingly
49
What percentage of FNA is accurate(free from error, exact, precise)?
84%-97%
50
What percentage of FNA is sensitive (proportion of actual positives which are correct)?
54%-95%
51
What percentage of FNA is specific (ability to identify patient without the disease)?
86%-100%
52
What are the 2 most common benign salivary gland tumors, commonly found in Parotid?
1. Pleomorphic adenoma | 2. Warthin's tumor
53
What is the most common of all salivary gland neoplasms?
Pleomorphic adenoma
54
Where does a pleomorphic adenoma commonly grow in the parotid gland of 40-60 year old females?
Superficial lobe near tail of the gland
55
Will pleomorphic adenoma be quick-growing and painful or slow growing and painless?
Slow-growing, painless
56
What is the treatment for pleomorphic adenoma?
Complete surgical excision with facial nerve preserved and avoid enucleation and tumor spill
57
What is a benign salivary gland tumor that is almost exclusive to the parotid (seen commonly in older, caucasian male smokers)
Warthin's tumor
58
What percentage of Warthin's tumors will be bilateral or multi centric?
10%
59
What percentage of Warthin's tumors that are attributed to smoking?
10%
60
What ist he more likely diagnosis of a palpable mass arising in a salivary gland, associated with pain, and / or nerve paralysis?
Malignant salivary gland tumor
61
Which is more suggestive of salivary gland malignancy, episodic pain or constant pain?
Constant pain. Episodic pain, on the other hand, is consistent with obstruction.
62
If a patient complains of trismus, cervical adenopathy, fixation, numbness, loose dentition, or bleeding associated with an enlarged salivary gland, what should be considered?
Malignancy
63
Why is it important to stage a salivary gland tumor that is malignant?
Guides if neck dissection is indicated
64
With respect to histology, the less well defined the histology, the better or worse the prognosis?
Worse
65
Can the histologic type of the tumor define the grade?
Yes, salivary duct carcinoma is higher grade than basal cell adenoma
66
What is the most common salivary gland malignancy?
Mucoepidermoid carcinoma
67
What age does mucoepidermoid carcinoma peak?
Fifth decade Females > males Caucasians > African Americans
68
A high-grade mucoepidermoid carcinoma will present with what symptoms?
Rapid enlargement and pain
69
What could a mucoepidermoid carcinoma in the minor salivary glands be mistaken for?
Inflammatory process, hemangioma, papilloma, tori
70
What is the treatment for Stage I or II mucoepidermoid carcinoma?
Wide local excision
71
What is the treatment for Stage III or IV mucoepidermoid carcinoma?
Radical excision Neck dissection Possible post op radiation therapy
72
Which has a better rate of 10 yr free of disease Low grade or High grade mucoepidermoid carcinoma?
Low grade (80% vs 42%)
73
Which has a higher rate of local recurrence within 10 yrs Low grade or High grade mucoepidermoid carcinoma?
Low grade (10% vs 6.4%)
74
With respect to mucoepidermoid carcinoma, if one is in the parotid gland and one is in the submandibular gland, and both tumors have the same histopathologic grade, which location has the better prognosis?
Parotid gland
75
What is the 2nd most common salivary gland malignancy?
Adenoid cystic carcinoma
76
What is the most common salivary gland malignancy in the submandibular, sublingual, and minor salivary glands?
Adenoid cystic carcinoma
77
An Adenoid Cystic Carcinoma has high recurrence rate and pt presents with facial weakness/paralysis due to what?
Tumor invades the nerve (neurotropism)
78
Where does Adenoid Cystic Carcinoma commonly recur after surgical and radiation treatment?
The base of the skull due to neurotropism
79
Due to neurotropism of Adenoid Cystic Carcinoma, what is usually sacrificed during complete local excision?
Facial nerve
80
What is the post op treatment for adenoid cystic carcinoma?
Post op radiation therapy with neutron beam
81
Where does the adenoid cystic carcinoma commonly have a distant metastasis?
Lung
82
What is the short=term versus long-term survival rate with adenoid cystic carcinoma?
High 5 year survival rate (75%) | Low 20 year survival rate (13%)
83
Would an osteosarcoma require neck dissection and why or why not?
No, because an osteosarcoma spreads by blood, not lymph
84
aving a node involved in the neck associated with a malignant salivary gland tumor, whether in the parotid or submandibular gland, decreases the 5 year survival to what percent?
9%
85
f the malignancy is considered high grade, or advanced stage tumor due to size, or histology is high risk (showing undifferentiated), what is there an increase risk of?
Occult neck metastasis
86
``` The following are all indications for what treatment? High grade malignancy Advanced primary tumor stage (T3-T4) High risk histology Tumor size >3cm Patient > 54 yrs old Facial paralysis Extracapsular, perilymphatic spread ```
Neck dissection
87
What are 2 advantages of neck dissection?
1. Pathologic staging | 2. Improved counseling and prediction of prognosis
88
What are 2 disadvantages of neck dissection?
1. Longer operating room time (and associated increased costs) 2. Increased complications (functional deficits, cosmetic effects)
89
A parotid gland malignancy would direct neck dissection to what levels?
II to IV
90
A submandibular gland malignancy would direct neck dissection to what levels?
I-III
91
What is an advantage of treating the neck with radiation versus dissection?
Avoids surgical sequelae
92
What are 2 disadvantages of treating the neck with radiation versus dissection?
1. Radiation effects on normal tissue | 2. Radiation induced malignancies
93
What are 2 cosmetic concerns when performing surgery on the parotid gland?
1. Design incision as with a facelift | 2. Monitor facial nerve during procedure to preserve
94
What is the relationship of the lingual nerve to the submandibular gland?
Gland is more lateral in the distal and more medial as it gets into the oral cavity

xD3 Oral Surgery Ex2 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions