H&N Cancer

Question 1

What is the most common type?

Answer 1

Larnyx

Question 2

Link the following types of cancer with their associated risk:

• nasopharyngeal
• oral cavity
• oropharyngeal
• laryngeal

Answer 2

Nasopharyngeal - EBV
Oral cavity - chewing tobacco
Oropharyngeal - HPV
Larynx - smoking and alcohol

Question 3

Nasopharyngeal cancer is rare in the UK apart from in what population?

Answer 3

South Chinese

Question 4

Tumours in the parotid gland are most likely to be benign. What kind of tumour are they most likely to be?

Answer 4

Pleomorphic adenoma

Question 5

What is the most appropriate investigation for neck mass?

Answer 5

FNA w/biopsy

Question 6

For how long would a patient have to have dysphonia before they need an urgent referral?

Answer 6

3 weeks

Question 7

Some patients will present with otalgia. This is due to referred pain via what nerve?

Answer 7

CN IX - glossopharyngeal nerve

Question 8

What investigation is better for imaging the nasopharynx and tongue base?

Answer 8

MRI

Question 9

What investigation is better for imaging the lymph nodes and larnynx?

Answer 9

CT neck and chest

Question 10

What is a panendoscopy?

Answer 10

Endoscopy of the

• pharynx
• larynx
• upper trachea
• oesophagus

Question 11

What are red flag symptoms of H+N cancer?

Answer 11

Dysphagia (in the neck)
Odynophagia
Dysphonia
Neck mass
Referred otalgia
Unilateral nasal symptoms with bloody discharge

Question 12

How is oropharyngeal and nasopharyngeal cancer managed

Answer 12

Chemo/radiotherapy

Question 13

If there is advanced laryngeal cancer what can be done?

Answer 13

Laryngectomy

Question 14

Tumours in what salivary glands are more likely to be metastic?

Answer 14

• Submandibular

- Sublingual

Question 15

What nerve is at risk of damage during partoidectomy?

Answer 15

Facial nerve - it branches off just beneath it