Head and Neck

Question 1

Malignancy of unknown primary found in neck, biopsy modality

Answer 1

Start with FNA and then to core needle. Do not do excisional if not prepared to do complete dissection.

Question 2

Next steps after biopsy proven carcinoma from neck mass

Answer 2

1. CT head/neck/chest with contrast
2. PET scan
3. through endoscopic evaluation of nasopharyngeal mucosa.

Question 3

Treatment for thyroglobulin negative/calcitonin negative neck mass

Answer 3

Neck dissection with adjuvant radiotherapy (or chemoradiation if extranodal extension)

Question 4

Hard signs of neck trauma indicating operative intervention

Answer 4

1. Hypotension/shock
2. Pulsatile bleeding
3. Expanding hematoma
4. Crepitus or air leaking through wound
5. Neurologic deficit
6. Airway compromise

Question 5

Non operative work up for penetrating neck injury

Answer 5

1. CTA neck
2. Esophagram +/- EGD
3. Laryngoscopy/bronchoscopy if concern for airway injury