ENT Neoplasms

Question 1

H and N cancer risk

Answer 1

50-70

Males

Laryngeal CA is most common

Question 2

H and N causes

Answer 2

Tobacco and alcohol explain 70%

90% are squamous cell CA

P16 expression negative in tobacco induced

Question 3

HPV

Answer 3

INduces p16

INfects basal epithelial cells

dsDNA virus

Induces squamous epithelial tumors

Question 4

Sino-nasal polyps

Answer 4

Can’t breathe through the nose

1/3 have associated allergies

Arise from sinus ostea

Topical and oral steroid tx

Question 5

Sinonasal tumors

Answer 5

Inverting papilloma - unilateral polyps

Carcinoma - rapidly enlarging and destructive

Angiofibroma - teenage boys with unilateral epistaxis

Question 6

Nasopharynx tumor

Answer 6

Nasal obstruction

Rhinorrhea

Snotring

ETD

Question 7

Otolaryngologic pseudohemoptysis

Answer 7

Hx of epistaxis

Coughing up blood

Hacking

Question 8

Bilateral vocal paralysis

Answer 8

Usually abductor
Inspiratory stridor
Phonation noram

BEWARE of airway obstruction

Question 9

Laryngeal caricnoma presentation

Answer 9

Flow loop with cutoff

Hoarseness for over 1 mo

Pain, dysphagia, odynophagia

New refractory dyspnea

Responsibe to steroids

Question 10

How to manage tumor obstruction

Answer 10

Prepare for surgical airway

Awake laryngoscopy with care

Flexible bronchoscopic intubiation with topical anesthesia

Awake cricothyrotomy

Question 11

Indications for tracheostomy

Answer 11

Prolonged need for mechanical ventilation

Bypass of upper airway obstruction

Need for pulm toilet

Inability to inbtubate airway safely in pt with need for intubation