11- Head And Neck Cancers and thyroid

Question 1

Most common type of malignancy in HNN cancer

Answer 1

Squamous cell carcinoma

Question 2

HNN risk factors

Answer 2

Smoking, alcohol, betal nut chewing, dental hygiene, HPV, premalignant

Question 3

Thyroid specific risk factors

Answer 3

Irradiation, family history (FAP)

Question 4

TNM staging

Answer 4

T- tumour
N- nodes
M- metastasis

Question 5

Presentation HNC

Answer 5

Unexplained painful mucosal ulceration or lesion, hoarseness voice, dysphagia, odynophagia. Cervical lymphodemopathy

Question 6

How to diagnose HNC

Answer 6

Clinical exam, biopsy, imaging CT MRI, endoscope

Question 7

5 types thyroid cancer

Answer 7

Papillary, follicular, hurthle, medullary, anaplastic

Question 8

presentation lip cancer

Answer 8

lump, pain, fixation Tonge, dysphasia, pain on swallowing

Question 9

investigations lip cancer and treatments

Answer 9

• biopsy, CT/MRI, PET

- excise small tumours, radiotherapy, extensive surgery for larger non RT responsive tumours

Question 10

presentation pharynx

Answer 10

lump- nodal, pain- referred to ear, dysphagia, swallowing pain, weight loss

Question 11

investigations treatment pharynx cancer

Answer 11

• CT/MRI, biopsy
• may need assistance for feeding with GI /NG tube (assisted feeding)
• excise small tumours, extensive surgery, radiotherapy

Question 12

presentation larynx

Answer 12

• dysphonia
• dysphagia
• globus (tightness/pressure int throat)
• referred otalgia
• neck lump
• weight loss
• cacexia

Question 13

investigations and treatment larynx

Answer 13

• CT/MRI, biopsy, PET
• resection small tumors, medium have RT and chemo
• large need laryngectomy

Question 14

presentation thyroid cancer

Answer 14

• lump
• problems swallowing, feeling strangled
• swallowing problems
• voice changes

Question 15

investigations thyroid cancer

Answer 15

• needle cytology

- ultrasound scan

Question 16

treatment thyroid cancer

Answer 16

• thyroidectomy
• radioactive iodine
• radiotherapy

Question 17

anterior relations thyroid

Answer 17

infrahyoid muscles, namely the sternothyroid, superior belly of the omohyoid and sternohyoid

Question 18

lateral relations thyroid

Answer 18

carotid sheath, containing the common carotid artey, internal jugular vein and vagus nerve

Question 19

medial relations thyroid

Answer 19

Organs – larynx, pharynx, trachea and oesophagus

Nerves – external laryngeal and recurrent laryngeal

Question 20

arterial supply thyroid

Answer 20

Superior thyroid artery

Inferior thyroid artery

Question 21

anatomical relations superior thyroid artery

Answer 21

• branch external carotid

- external branch of superior laryngeal nerve

Question 22

anatomical relations inferior thyroid

Answer 22

• branch subclavial>thyrocervical trunk

- recurrent laryngeal nerves

Question 23

venous drainage thyroid

Answer 23

superior, middle, and inferior thyroid veins, which form a venous plexus around the thyroid gland.

Question 24

innervation thyroif

Answer 24

branches derived from the sympathetic trunk.

Question 25

lymphatic drainage of thyroid

Answer 25

paratracheal and deep cervical nodes.

Question 26

relationship of recurrent laryngeal nerves to the thyroid gland

Answer 26

• emerge from vagus and hook under SCA on RHS or AoA on LHS
• recurrent then runs back up neck between trachea and vagus in transoesophogeal groove
• passes underneath thyroid to innervate larynx