Cervical Swellings and Stick Injuries

Question 1

Pharyngeal stick injury
-early CS (4)
-late CS (3)
Trajectories:
-rostral (3)
-lateral (4)
-dorsal (3)

Answer 1

-early CS : dull, bloody saliva, pain on opening mouth, anorexic
-late CS: discharging sinus, air in facial planes, FB radiolucent
Trajectory:
-rostral : retrobulbar area, masseteric muscles, temporal region
-lateral: tongue, tonsil, lateral to larynx, cervical region
-dorsal: dorsal pharyngeal wall, retropharyngeal structures, oesophagous

Question 2

Stick injuries CS for sites

• temperal/masseteric (2)
• cervical (2)
• retropharyngeal (3)

Answer 2

• temperal/masseteric: retrobulbar swelling and pain
• cervical: abscess and discharging sinus
• retropharyngeal: sinuses, oesophagus rupture, mediastinitis

Question 3

Stick injuries

• Tx
• retrobulbar DDx
• CS of oesophageal involvement (3)

Answer 3

• DON’T send home: explore all tracts, rigid scope, repair any tears
• retrobulbar: check ear for problem, ensure it’s not dental (usually further forward and closer to the eye)
• subcutaneous oedema, dyspnoea, pneumomediastinitis

Question 4

Sialocoele

• what
• presentation
• Dx
• Tx
• SE of Tx

Answer 4

• defect in polystomatic sublingual gland
• soft, painless swelling that is not attached to any underlying tissues
• Dx: drip test of aspirated honey-coloured fluid: tenacious
• Tx: remove polystomatic part of sublingual gland (at least 2 lobules) and put in penrose drain
• must also remove submandibular and sublingual to get to it

Question 5

Thyroid Carcinoma

• presentation
• CS (3)
• growth
• surgical problems

Answer 5

• mid cervical mass, attached to underlying tissue NOT the skin
• CS: coughing, regurgitation, firm mass (venro-lateral to larynx)
• grows slowly
• beware of retropharyngeal nerve, carotid artery, jugular vein, trachea, oesophagous

Question 6

Retropharyngeal abscess

• CS (2)
• Presentation
• Tx

Answer 6

• CS: pain and pyrexia
• attached to skin and underlying tissues
• Tx: drain

Question 7

Sialadenitis

• predisposition
• CS (4)
• Tx (3)

Answer 7

• young animals
• CS: PAIN, pyrexia, hypersalivation, looks like mumps
• Tx: steroids/NSAIDs, hypersalivation, phenobarbitol

Question 8

Calcinosis circumscripta

• what
• Tx

Answer 8

• firm, painless mass attached to ventrolateral aspect of ventebrae
• leave well alone unless interfering with shoulder joint