Disease of Head and Neck - Ears, Neck, larynx and glands Flashcards
Otitis Media
Infection of middle ear
usually viral with superimposed bacterial
Common in children
Acute - Strep pneumonia, H. influenza
Chronic - P. aeroginosa, Staph aureus
Diabetes - aggressive and destructive otitis from P. aeruginosa
Can lead to eardrum perforation
Cholesteatoma
keratinous cyst due to repeated bouts of otitis media
Can rupture and cause local inflammatory reaction
Otosclerosis
Abnormal bone deposition in middle ear - mostly stapes
Hearing loss
Usually familial
Ear tumors
Basal cell and Squamous cell cancers - don’t metastasize but lethal
Brachial Cleft Cyst
Benign remnant
Near SCM
Early adulthood
Fluid filled
Thyroglossal Duct Cyst
Thyroid migration remnant Anterior midline neck, base of tongue Any age Squamous or respiratory lining can develop tumors
Paraganglioma
Arises from paraganglia - neuroendocrine cells
Adrenal medulla, Carotid body *
Slow growing tumor
May be malignant
AKA - carotid body tumor
Arises in cells from carotid body - near bifurcation
can locally invade, engulf carotid
Sustenacular cells - Balls of cell - Zellballen
Laryngitis
infectious, chemical, smoking, toxins
Main findings - erythema, swelling, inflammation and focal ulceration
wheezing - do a tracheostomy
laryngoepiglottitis
Hemophilus Influenza
Dangerous in kids - airway obstruction
Croup -inspiratory stridor from inflammatory narrowing of airway - often caused by parainfluenza virus
Laryngeal nodules and polyps
Yelling, singing or smoking
benign
nodules are bilateral
polyp is unilateral
laryngeal papillomas
Benign squamous proliferations common on true vocal cords typically unilateral associated with HPV 6 and 11 In kids, multiple papillomas can lead to airway obstruction Histology - Koilocytes**
Laryngeal carcinoma
95% are squamous cell carcinoma
Risk factor - cigarette smoking, alcohol
mass - it is this until proven otherwise
Hyperplasia –> dysplasia –> carcinoma seq
Mostly on true vocal cords
treatment - removal and irradiation
prognosis - 1/3rd die of disease
Xerostomia
Dry mouth
Causes - Sjogren Syndrome
Drugs - anticholinergics, antipsychotics, diuretics, antihistamines, antihypertensive
Complications - dental caries and candidiasis
Sjogren’s Syndrome
Chronic disease with dry mouth (xerostomia) and dry eyes (keratoconjunctivitis sicca) resulting from AI destruction of salivary and lacrimal glands
could be primary or secondary to RA or Lupus
Mikulicz Disease
used to describe the inflammatory reaction seen in salivary glands in sjogren’s syndrome
Marked lymophocytic infiltrates and germinal centers
proliferation of ductal epithelium
may develop secondary lymphomas