Chapter 14 - Salivary Gland Flashcards
Retromandibular vein
Formed by maxillary and sup temp vv
This and posterior auricular v form EJ
How to find Stensen’s Duct
Superficial to masseter
Adjacent to 2nd upper molar
Relationship of whartons Duct and lingual nerve
Duct deep to nerve
This is SM gland Duct
Treatment of sialadenitis
Abx with B lactamase resistance (Augmentin)
Hydrate, warm compress, sialogogue (lemon wedges)
Sialolithiasis Tx
Sialogogue, warm, ABx, hydrate
Sialolithotomy
Sialoemdoscopy
Excise gland
Mumps
4-6yo, possible even with vacc
Bilat
Orchitis, encephalitis, SNHL
HIV parotid dz
Lymphoepithelial cystic disease
Causes of salivary granuloma dz
TB, Bartonella, Mycobacterium, Actinomyces, Sarcoid
Also Toxo- treat with pyrimethamine, sulfadiazene, folinic acid
Benign salivary tumor order of incidence
Pleo Warthin (F 50-60 smoker, 10% bilat) Cyst Lymphoepith Oncocytoma Mono Adenoma
Malignant salivary tumor order incidence
Mucoepi (2nd most common overall, more mucinous the better)
Adenoid cystic (solid worst, then cribiform, tubular)
AdenoCA
Mixed
Acinic cell (3-5% bilat)
Epidermoid CA
Workup salivary mass
FNA Bx
CT with con
Salivary T Stage
3:>4cm or extraparenchymal
4a: skin, mandible, ear canal, VII
b: SB, pterygoid plate, encase ICa
Hayes Martin maneuver
Lígate facial av, lift up
Gets marg out of way during SM gland removal (marg runs deep to vessels)
7 ways to find facial nerve
1cm Inf/Deep to TP
6-8mm A/I To TMSL
Sup to cephalic portion PD
Sup/lat to styloid
Find marg where passes over facial av at Ant Masseter border
Find zyg branch as go over arch 2/3 from tragus to lat canthus
Mastoidectomy
Indications for Post-op Rads after parotid neoplasm
High grade Residual disease LN Mets Extraparotid ext Involve VII Deep lobe (sometimes) Recurrence
