7.2.3 Head and Neck Abnormalities Flashcards
Where will 3rd and 4th branchial cleft anomalies be located?
Lower 1/3 of anterior neck
Sinus/fistula ends in pyriform sinus
Associated with thyroid gland
What are the derivatives of the 6th arch? (Cartilage, muscle, artery, CN)
What is the management of 3rd and 4th branchial cleft anomalies?
+/- hemithyroidectomy
direct laryngoscopy
endoscopic cauterization
What are some malformations associated with a 1st pouch anomaly?
Eustachian tube dysfunction - recurrent ear infections
Absent tympanic cavity - CHL
Absent mastoid cavity
Condition? Type of anomaly?
Pierre Robin Sequence; 1st arch anomaly
What are the two branchial cleft anomalies? Why is it important to distinguish b/t them?
Type 1 and Type 2
Important to distinguish b/t them because of their relationship to CNVII. Type 1 is always lateral to CNVII. Type 2 can be lateral or medial
What condition?
Treacher Collins
What type of anomaly is DiGeorge syndrome? What are the presenting features?
3rd & 4th Pouch anomaly
CATCH-22
Cardiac anomalies
Abnormal facies
Thymic aplasia
Cleft palate
Hypocalcemia
22nd chromosome deletion 22.q
What type of vascular anomaly is associated with a 4th arch anomaly?
Double aortic arch
What type of anomaly will present with chronic drainage from areas around the EAC, angle of mandible, SCM? These can get infected. If so, what is the treatment?
Branchial cleft anomaly
Abx, Avoid I&D and surgery by 3-4 y/o (CT and MRI often used to confirm diagnosis)
What type of vascular anomaly is associated with a 6th arch anomaly?
Pulmonary artery sling
What are some features of hemifacial microsomia?
Malformed auricle - microtia/anotia
Ossicular malformation - stapes, malleus, incus, CHL
Facial muscle assymmetry
Hyoid malformation
What surgery can be done in attempt to correct the micrognathia of Piere Robin sequence?
Mandibular Distraction
What are the derivatives of the 4th arch? (Cartilage, muscles, artery, CN)
How will 2nd branchial cleft anomalies present? Their location?
Painless, fluctuant cyst, sinus, or fistula in anterior triangle
Anterior border of SCM
What are some of the important aspects in the initial management of patients with Piere Robin Sequence?
Avoid respiratory distress (nasal airway, positioning, tongue lip adhesion, intubation)
Feeding (Habermann nipple, special bottle
What type of anomaly is hemifacial microsomia?
2nd arch anomaly
What type of anomaly is a thyroglossal duct cyst?
3rd and 4th pouch
What presents as reddish mass at the base of the tongue and is a result of failed descent?
Lingual thyroid - complete failute of thyroid descent
Where are thyroglossal duct cysts located along the neck?
Midline; may move/elevate with protrusion of the tongue
What are some of the presenting features of Treacher Collins?
Midface & Mandibular hypoplasia
Cleft Palate
Ear: CHL (conductive hearing loss), microtia, atresia
What is the genetics of Treacher Collins?
AD, variable penetrance
What are the derivatives of the second second arch? (Cartilage, Muscle, Artery, CN)
What type of vascular anomaly is associated with a 3rd arch anomaly?
Carotid artery aneurysm
What is used to evaluate TGDC and lingual thyroid? What are the management options?
What are the features of Pierre Robin Sequence?
- Micrognathia
- Glossoptosis (posterior displacement of tongue)
- Cleft palate (U-shaped)
Name the condition and type of anomaly
Treacher Collins; 1st arch anomaly
What are the derivates of the 3rd arch? (cartilage, muscles, artery, CN)
What surgery can be done after mandibular distraction to correct the u-shaped cleft palate of Piere Robin sequence?
Palatoplasy
What is the most common branchial anomaly?
2nd branchial cleft
What are the derivatives of the 1st arch? (Cartilage, Muscle, Artery, CN)
What is the most common congential neck mass?
Thyroglossal duct cyst - failure of complete obliteration of the thyroglossal duct
