HEAD AND NECK

Question 1

Most common sight of unknown primary of head and neck

Answer 1

starts in tonsil and goes cephlad for the frist 3 most common –>

1. tonsil
2. base of tongue
3. nasopharyngeal
4. hyper pharynx

Question 2

Treatment of mediastinitis from tooth abscess

Answer 2

Must during this

Chest tubes

Question 3

Workup and treatment of unknown primary

Answer 3

Triple endoscopy

pharyncgo laryngoscopy
Bronch
EGD

Probably get CT scan the Head neck and chest

Question 4

Treatment of unknown primary

Answer 4

Only XRT is an option

If you do in pure neck dissection

Levels 2-5 (same as medullary carcinoma)

NO chemo

Question 5

Management of thoracic duct leak after operation

Answer 5

Operate first in the neck

If you can’t find in the neck:
Go to the chest

Question 6

Work up of unknown primary head and neck

Answer 6

Triple endoscopy
pharyngolaryncoscopy
Bronchoscopy
EGD

CT scan Head neck and chest

Biopsy:
Tonsillar pillar
Basis tongue
Performis sinus

Question 7

Treatment of unknown head and neck primary

Answer 7

Modified radical neck dissection (Chris / Osler)

XRT