64 Diseases of head + neck Flashcards
What is the most common malignant tumour of the oral cavity and larynx?
Squamous cell carcinoma.
What is the long term survival for squamous cell carcinoma in the oral cavity?
50%
Where do squamous cell carcinomas of the mouth commonly arise? (6)
Floor. Ventrolateral tongue. Retromolar region. Lower lip. Soft palate. Gingiva.
How does squamous cell carcinoma of the oral cavity commonly present? (4)
Pain.
Difficulty swallowing/speaking.
Numbness/tingling of the tongue.
White/dark patches.
What is the aetiology of carcinoma of the oral cavity? (6)
Tobacco + alcohol (synergistic).
Smokeless tobacco containing areca nut + calcium hydroxide.
HPV.
Meat + red chilli powder.
What are the important genetic changes that occur in carcinoma of the oral cavity? (3)
Inactivation of p16 + p53.
Over activation of cyclin-D (increased cell motility).
Which conditions/lesions are precancerous to oral carcinoma? (6)
Submucous fibrosis. Actinic keratosis. Lichen planus. Leukoplakia and erythroplakia. Chronic hyperplastic candidosis.
What is the aetiology of carcinoma of the larynx? (9)
Tobacco. Alcohol. HPV 6 + 11. Dietary: Salt, preserved meats, dietary fats. Metal/plastic workers. Work: exposure to paint, diesel and gasoline fumes, asbestos. Exposure to radiation. Laryngopharyngeal reflux. Genetic.
Where do most carcinomas of the larynx arise?
On the true vocal cords.
What are the symptoms of carcinoma of the larynx? (4)
Hoarseness.
Pain.
Haemoptysis.
Dysphagia.
Lesions in Lichen planus? (3,2)
Pathogenesis?
Who?
Cutaneous: itchy, purple papules + Wickham’s striae.
Oral: reticular striations, ulcerative lesions.
T cell autoimmune.
Middle aged females.
What are vocal cord nodules/polyps?
Who are they seen in? (3)
Symptoms?
Benign reactive lesions.
Heavy smokers/singers. Adult men.
Hoarseness and increasing effort.
What is the aetiology of nasal polyps?
Effects?
Histology? (3)
Recurrent rhinitis leading to mucosal folds.
Large/multiple may stop sinus drainage - sinusitis.
Oedematous mucosa, hyperplastic mucous glands, eosinophil infiltrate.
What is the aetiology of sinusitis? (2)
Which are most affected? (2)
Acute/ chronic rhinitis or extension of upper tooth infection through antrum.
Frontal, anterior ethmoid.
Which bacteria are found in sinusitis?
Mixed oral.
Fungal if severe: mucomycosis in diabetics.
What is a cholesteatoma?
Associated with?
Cystic lesions filled with cholesterol. May precipitate foreign body giant cell reaction.
Chronic otitis media.
What is otosclerosis?
Pathogenesis?
Results in?
Bilateral abnormal bone deposition in middle ear. Familial.
Fibrous ankylosis - bony overgrowth - anchorage of middle ear bones to oval window.
Marked hearing loss.
What is labyrinthitis?
Symptoms?
Causes? (4)
Inflammatory disorder of the inner ear.
Disturbed balance + hearing.
Bacterial, viral, Wegner’s granulomatosis, poyarteritis nodosa.
What is Ramsay Hunt syndrome?
VZV in sensory ear nerves causing labrynthitis and facial paralysis.
Which cancers affect the external ear?
Associated with?
Who?
Basal cell and squamous cell carcinomas.
Actinic radiation (sun).
Elderly men.
In the ear canal, which cancer is most commonly seen?
In who?
Squamous cell carcinoma.
Women.
What is a paraganglioma?
Symptoms? (5)
Who?
Behaviour?
Middle ear tumour.
Pulsatile tinnitus, hearing loss, aural pressure, pain, bloody otorrhea (discharge).
Middle aged women.
Very locally aggressive.
What are the causative organisms in acute otitis media? (3)
Streptococcus pneumoniae
H. influenzae
Moraxella catarrhalis
What is serous otitis media?
Eustachian tube obstruction results in serous fluid build up in middle ear.
