face Flashcards
what causes ramsay hunt syndrome
reactivation of varcilla zoster virus in geniculate ganglion of CNVII
symptoms ramsay hunt sydnrome
auricular pain // facial nerve palsy // vesicular rash on ear // vertigo + tinnitus
mx ramsay hunt syndrome
oral aciclovir + steroids
function CNVII
muscles facial expression + nerve to stapedius // ant 2/3 taste tongue // parasympathetic fibres to tears + salivary glands
causes bilateral facial nerve palsy
sarcoid // GBS // lyme // bilateral acoustic neuroma
causes unilateral facial palsy
Bells // ramsay hunt // acoustic neuroma // parotid // HIV
facial LMN vs UMN
UMN spared forehead
causes unilateral facial UMN
stroke
where does CNVII pass through
tempiral bone –> internal auditory meatus (alongside vestibulococlear nerve) –> combine togetehr to become facial nerve –> through parotid
branches CNVII
greater petrosal // nerve to stapedius // chorda tympani
features bells palsy
LMN facial palsy (includes forehead) // post-auricular pain // altered taste, dry eyes // hyperacusis (facial nerve palsy)
age bells palsy
20-40 (common in pregnancy)
what is thought to cause bells palsy
herpes simplex
mx bells palsy
oral pred within 72hrs // eye care (eg artificial tears) // antivirals
what warrants referral to ENT in bells palsy
paralysis not improving at 3 weeks
how long does bells last
3-4 months
symptoms trigeminal neurlagia
severe unilateral pain on face // triggered by light touch
mx trigeminal neurlagia
carbamezepine
symptoms temporal bone fracture
battle sign behind ear // tinnitus, hearing loss, discharge from ear, CNVII/VIII damage
what are the 3 pairs of salivary glands
parotid // submandibular // sublingual
where do most tonsil stones occur
submandibular
symptoms of salivary stones
unilateral pain + swelling on eating // smell bad
invx salivary stones
plain x ray
what can cause ludwigs angina
infected salivary stones // tooth infection –> submandibular space
what is ludwigs angina
cellulitis that invades the floor of the mouth + soft tissue of the neck
symptoms ludwigs angina
neck swelling, dysphagia, fever, airway obstruction
mx ludwigs angina
airway + IV abx
where do the majority of salivary gland tumours occur
parotid
what is a pleomorphic adenoma
most common tumour of parotid gland - benign
symptoms + o/e pleomorphic adenoma
men 50s // slow growing, painless, unilateral swelling // mobile
why do pleomorphic adenoma need removed
risk of malignant transformation (2-10% if not excised)
symptoms warthins tumour
bilateral // males 60-70
type of parotid tumour seen in children <1
haemangioma
most common parotid malignant tumour
mucoepidermoid carcinoma
invx parotid tumours
xrays (for stones) // FNAC!! // CT or MRI for malignancy
mx parotid tumour
benign = superficial parotidectomy // malignant = radical
HIV manifestation in parotid
lymphoepithelial cysts - bilateral
