1 - ENT pathology Flashcards
what is histology of external ear and middle ear?
external = lined by dermis (has sebaceous & ceruminous glands)
middle ear = lined by columnar mucosa
what epithelium lines nose?
- nasal vestibule = squamous epithelium
- nose, sinus etc = respiratory epithelium (pseudostratified ciliated columnar)
what is cholesteatoma?
= it’s an abnormal collection of cells (keratin) in ear (any age)
= eardrum has sucked in (dead skin builds up in middle ear) as keratin builds up, it erodes bone
what is seen in otoscopy of cholesteatoma?
pearly white mass in middle ear - see squamous epithelium & abundant keratin
what is vestibular schwannoma? presents?
benign tumour assoc with CN VIII
PRESENT - unilateral sesnsorineural hearing loss, tinnitus, loss balance, headaches, potential compression of other CNs or structures
- link with neurofibromatosis type 2 (bilateral & young)
what is palisading of nuclei - rocky bodies associated with?
vestibular schwannoma
what are nasal polyps? management?
= inflammatory polyps in adults, lots of causes (hypersensitivity, aspirin sensitivity, cystic fibrosis)
- manage with intranasal steroids
what are sinonasal papillomas?
= unilateral benign tumour in men over 50, assoc w HPV
3 types - inverted, exophytic, oncoytic
what is nasopharyngeal carcinoma?
aggressive malignant tumour. risk factor if EBV, nitrosamines in food, smoking, alcohol
EBV & HPV = associated with non-keratinising subtypes
smoking & alcohol associated with keratinising
what are laryngeal polyps?
reactive change in laryngeal mucosa = associated with vocal abuse, infection, smoking
what is contact ulcer?
benign response to injury - mostly on posterior vocal cord
assoc with chronic voice clearing, voice abuse, GORD, intubation
what is squamous cell papilloma?
= benign tumour of throat common in under 5s or between 20-40
- caused by HPV (6&11)
what is paraganglioma?
= tumours arising in cluster of neuroendocrine cells (anywhere in body) but parasympathetic ones common in head & neck region around carotid or aortic bodies
- assoc MEN2
what is high risk subtypes of HPV?
HPV 16 most then HPV 18
what is most common malignant tumour of throat?
squamous cell carcinoma
= related to smoking & alcohol unless nasopharynx then most associated with HPV
what is sialolithiasis?
stones in salivary gland = obstruction
what is most common gland for tumours?
parotid
what virus causes mumps?
paramyxoma virus
what are 4 examples of salivary gland tumours?
- pleomorphic adenoma (most common, benign, slow growing, female)
- warthin’s tumour (bilateral, smoking, benign)
- mucoepidermoid carcinoma (malignant)
- adenoid cystic carcinoma (common for palette, poor prognosis, recurs)
what is presentation of acoustic neuromas/vestibular schwannomas? investigation?
- unilateral sensorineural hearing loss
- unilateral tinnitus
- dizziness or imbalance
- sensation of fullness in ear
- facial nerve palsy (if big enough tumour)
= investigate w MRI (remove surgically)
what is suggested if bilateral vestibular schwannoma?
if bilateral (and young) then suggests neurofibromatosis type II
what is presentation of cholesteatoma?
- unilateral conductive hearing loss
- constant foul smelling discharge
- as expands could get infection, pain, vertigo, facial palsy
what is management of cholesteatoma?
mastoid surgery to remove cholesteatoma
what should you think if child with nasal polyps?
think cystic fibrosis
