Developmental Disturbances of the Oral and Maxillofacial Region Flashcards
Define macule
A focal area of color change which is not elevated or depressed in relation to its surroundings
Define papule
A solid, raised lesion which is less than 5 mm in diameter
Define nodule
A solid, raised lesion which is greater than 5 mm in diameter
Define sessile
Describing a tumor or growth whose base is widest part of the lesion
Define pedunculated
Describing a tumor or growth whose base is narrower than the widest part of the lesion
Define papillary
Describing a tumor or growth exhibitnig numerous surface projections
Define verrucous
Describing a tumor or growth exhibiting a rough, warty surface
Define vesicle
A superficial blister, 5 mm or less in diameter, usually filled with clear fluid
Define bulla
A large blister, greater than 5 mm in diameter
Define pustule
A blister filled with purulent exudate (pus)
Define ulcer
A lesion characterized by loss of the surface epithelium and frequently some of the underlying connective tissue. It often appears depressed or excavated
Define erosion
A superficial lesion, often arising secondary to rupture of a vesicle or bulla, that is characterized by partial or total loss of surface epithelium
Define fissure
A narrow slit like groove
Define plaque
A lesion that is slightly elevated and is flat on its surface
Define petechia
A round pinpoint hemorrhage
Define ecchymosis
A non-elevated area of hemorrhage, larger than a petechia (a bruise)
Define telangiectasia
A vascular lesion caused by dilatation of a small superficial blood vessel
Define a cyst
A pathologic epithelium-lined cavity, often filled with liquid or semi-solid contents (histologic diagnosis)
Define unilocular
Describing radiolucent lesion having a single compartment
Define multilocular
Describing a radiolucent lesion having several or many compartments
7 types of cleft lip and cleft palate
- Incomplete cleft lip
- Complete cleft lip
- Bilateral cleft lip
- Cleft uvula
- Incomplete cleft palate
- Unilateral cleft lip and palate
- Bilateral cleft lip and palate
When to surgically repair cleft lip
During first month
When to surgically repair cleft palate
During first 18 months
4 characteristics of congenital lip pits
- Located in paramedial portion of upper or lower lip, or labial commissure
- Unilateral or bilateral
- Blind 1-3 mm pore or pit
- Requires no treatment
3 characteristics of double lip
- Redundant mucosal tissue seen as a horizontal fold
- Congenital or acquired
- No treatment required
3 components of Ascher syndrome
- Double lip
- Blepharochalasis
- Non-toxic goiter
3 characteristics of frenal tag and treatment
- Maxillary labial frenum
- Redundant tissue seen as a 1-2 mm papule
- No treatment required
- Recommend observation
Define anyloglossia
Restriction of the tongue by an abnormally short and anteriorly positioned lingual frenum
2 potential consequences of ankyloglossia
- May interfere with speech
- May attach to the gingiva and cause gingival recession
Treatment for ankyloglossia
Excision - electrocautery
3 syndromes in which macroglossia is congenital
- Down
- Beckwith-Wiedemann
- MENIII
5 conditions in which macroglossia is secondary
- Hemangioma
- Lymphangioma
- Amyloidosis
- Acromegaly
- Congenital hypothyroidism
Diagnose
Lymphangioma
Diagnose
Hemangioma
Diagnose
Amyloidosis
Define fordyce granules
Collections of sebaceous glands
4 characteristics of fordyce granules
- Bilateral buccal mucosa and upper lip
- Multiple small 1-2 mm yellowish submucosal dots
- Normal
- Adenomatous hyperplasia may occur and be seen as a larger yellow papule
4 characteristics of leukedema
- Buccal mucosa bilaterally
- Asymptomatic
- Translucent, grayish-white, filmy appearance
- Due to accumulation of intracellular fluid (edema) and glycogen
How to diagnose leukedema
- Perform the stretch test
- Leukedema should disappear or be greatly reduced
- If not, think leukoplakia
5 characteristics of white sponge nevus
- Genodermatosis
- Autosomal dominant inheritance
- Asymptomatic white shaggy lesion
- Bilateral, typically affecting the buccal mucosa
- May involve the esophageal, anal, vulvar and vaginal mucosa
Diagnosis and treatment of white sponge nevus
- Diagnosis can be confirmed with a smear stained with the PAP stain
- No treatment necessary
4 characteristics of lingual thyroid nodule
- Rare
- Mass of thyroid tissue on midposterior dorsum of tongue
- Failure of migration
- Females = puberty and adolescence
Management of lingual thyroid nodule
Before excision determine if there is function tissue in the neck (I-131 scan)
Possible synthroid required?
Define oral tonsil
Intraoral lymphoid tissue
Components of the Waldeyer ring
Palatine + adenoids + lingual tonsils
Define lingual tonsils
Intraoral lymphoid tissue on the posterior lateral borders of the tongue
Define foliate papillitis
Condition in which the tonsils may become hyperplastic in response to infection or inflammation
Define retrocuspid papilla
2 - 4 mm slightly raised area of mandibular alveolar mucosa lingual to the cuspids
5 characteristics of hemifacial hypertrophy
- Significant unilateral enlargement of face involving facial soft tissues, bone and teeth
- Increased neurovascular supply?
- Hypertrichosis, enlarged fungiform papilla
- Malocclusion
- +/- Wilm’s tumor
Define hemifacial atrophy (5 characteristics)
- Progressive decrease in the size of one side of the face
- Due to ?Nerve dysfunction, trauma, infectoin, unilateral progressive systemic sclerosis
- Begins in 1st or 2nd decade
- Skin, muscle and bone affected
- Hyperpigmented skin, furrow midline forehead
Define osteoporotic bone marrow defect
Ill-defined radiolucency in an edentulous area of the mandible previously occupied by a tooth. Asymptomatic - no swelling
Management of osteoporotic bone marrow defect
Biopsy/ curettage
Define stafne bone defect
Lingual mandibular salivary gland depression. A developmental concavity of the mandible that forms around an accessory lobe of submandibular salivary gland
Radiographic appearance of stafne bone defect
Well circumscribed BELOW the mandibular canal
Describe how hyperplasia of salivary gland tissue occurs
When an edentulous space has been present for many years and the soft tissues and underlying salivary tissue protrudes into the space.
Asymptomatic; tissue is soft
Location of nasopalatine duct cyst
Developmental intraosseous cyst (teeth vital) in the midline anterior palate
Origin of nasopalatine duct cyst
Rests from embryonic nasopalatine duct
Radiographic appearance of nasopalatine duct cyst
Well circumscribed oval/heart shaped radiolucency
Treatment of nasopalatine duct cyst
Surgical enucleation
location of cust of the incisive papilla
Entirely in soft tissue
NOTE: No radiographic findings
Location of nasiolabial cyst
In soft tissues of anterior mucobuccal fold beneath ala of the nose (Klestadt cyst)
NOTE: Rare - occur in 4th or 5th decade
Origin of nasolabial cyst
Remnants of nasolacrimal duct
Treatment for nasolabial cyst
Surgical enucleation
2 types of lymphoepithelial cysts
- Oral lymphoepithelial cysts
- Cervical lymphoepithelial cysts (branchial cleft cyst)
Locations of oral lymphoepithelial cysts
- Develops where oral tonsils are found
- Anterior floor of mouth
- Posterior lateral border of tongue
- Soft palate
- Oropharynx
Describe appearance of oral lymphoepithelial cysts
- Asymptomatic
- 5 mm yellowish or tan submucosal mass
Treatment for oral lymphoepithelial cysts
Conservartive surgical excision
Location of cervical lymphoepithelial cysts
Lateral aspect of the neck, usually anterior to the SCM muscle –> epithelium (salivary gland) in lymphoid nodes
Describe the presentation of cervical lymphoepithelial cysts
- Late childhood/early adulthood onset
- Painless swelling +/- draining fistula
- Squamous cell carcinoma does not arise in lymphoepithelial cysts - if present, suspect metastatic carcinoma
Treatment for cervical lymphoepithelial cysts
Surgical excision
Describe the presentation of parotid lymphoepithelial cysts
- Multiple parotid cysts
- Cervical lymphadenopathy
Disease to suspect in presence of parotid lymphoepithelial cysts
HIV
Location of thyroglossal tract cyst
- Anywhere from base of tongue to anterior midline of neck
- Mostly below hyoid bone
NOTE: Children and young adults; may contain thyroid tissue
Treatment for thyroglossal duct cyst
Surgical excision - Sistrunk procedure - removal of portion of hyoid bone to reduce likelihood of reoccurence
Location of dermoid cyst
Around skin of eyes, upper neck or floor of mouth
Describe the presentation of dermoid cyst
- Teenagers
- Cystic teratoma
- Painless mass of doughy consistency
Treatment for dermoid cyst
Surgical excision
Define epidermoid cyst
- “Sebaceous” cyst of skin
- Lined by stratified squamous epithelium
- Occasional intraoral cases
Location of surgical ciliated cyst of the maxilla
Intraboney cyst near the floor of the maxillary sinus
Cause of surgical ciliated cyst of the maxilla
Iatrogenic due to Caldwell-Luc operation –> maxillary sinus lining that becomes implanted in bone
Radiographic appearance of surgical ciliated cyst of the maxilla
Well circumscribed radiolucency
Treatment for surgical ciliated cyst of the maxilla
Surgical management
Location of heterotopic oral gastrointestinal cyst
Tongue or floor of mouth (rare)
NOTE: Infants and children
Treatment for heterotopic oral gastrointestinal cyst
Excision
