11- Head And Neck Cancers and thyroid Flashcards
Most common type of malignancy in HNN cancer
Squamous cell carcinoma
HNN risk factors
Smoking, alcohol, betal nut chewing, dental hygiene, HPV, premalignant
Thyroid specific risk factors
Irradiation, family history (FAP)
TNM staging
T- tumour
N- nodes
M- metastasis
Presentation HNC
Unexplained painful mucosal ulceration or lesion, hoarseness voice, dysphagia, odynophagia. Cervical lymphodemopathy
How to diagnose HNC
Clinical exam, biopsy, imaging CT MRI, endoscope
5 types thyroid cancer
Papillary, follicular, hurthle, medullary, anaplastic
presentation lip cancer
lump, pain, fixation Tonge, dysphasia, pain on swallowing
investigations lip cancer and treatments
- biopsy, CT/MRI, PET
- excise small tumours, radiotherapy, extensive surgery for larger non RT responsive tumours
presentation pharynx
lump- nodal, pain- referred to ear, dysphagia, swallowing pain, weight loss
investigations treatment pharynx cancer
- CT/MRI, biopsy
- may need assistance for feeding with GI /NG tube (assisted feeding)
- excise small tumours, extensive surgery, radiotherapy
presentation larynx
- dysphonia
- dysphagia
- globus (tightness/pressure int throat)
- referred otalgia
- neck lump
- weight loss
- cacexia
investigations and treatment larynx
- CT/MRI, biopsy, PET
- resection small tumors, medium have RT and chemo
- large need laryngectomy
presentation thyroid cancer
- lump
- problems swallowing, feeling strangled
- swallowing problems
- voice changes
investigations thyroid cancer
- needle cytology
- ultrasound scan
treatment thyroid cancer
- thyroidectomy
- radioactive iodine
- radiotherapy
anterior relations thyroid
infrahyoid muscles, namely the sternothyroid, superior belly of the omohyoid and sternohyoid
lateral relations thyroid
carotid sheath, containing the common carotid artey, internal jugular vein and vagus nerve
medial relations thyroid
Organs – larynx, pharynx, trachea and oesophagus
Nerves – external laryngeal and recurrent laryngeal
arterial supply thyroid
Superior thyroid artery
Inferior thyroid artery
anatomical relations superior thyroid artery
- branch external carotid
- external branch of superior laryngeal nerve
anatomical relations inferior thyroid
- branch subclavial>thyrocervical trunk
- recurrent laryngeal nerves
venous drainage thyroid
superior, middle, and inferior thyroid veins, which form a venous plexus around the thyroid gland.
innervation thyroif
branches derived from the sympathetic trunk.
lymphatic drainage of thyroid
paratracheal and deep cervical nodes.
relationship of recurrent laryngeal nerves to the thyroid gland
- 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
