head and neck cancer

Question 1

what are the usual presenting symptoms of head and neck cancer?

Answer 1

Dysphonia – >3 weeks warrants urgent referral for laryngoscopy

Dysphagia – particularly if progressive & chronic

Odynophagia - chronic

(Unilateral) otalgia – if no other cause (remember referred pain)

Neck lump

Can present with airway obstruction - Stridor

Question 2

where do supra-glottic tumours drain to?

Answer 2

superior deep cervical nodes

Question 3

describe glottic tumours

Answer 3

Present on the cords
95% stay on the cords
Minimal lymphatic drainage
Presents with voice changes/airway obstruction

Question 4

how do sub-glottic tumours present?

Answer 4

voice / airway obstruction

Question 5

where do sub-glottic tumours drain to?

Answer 5

paratracheal nodes

Question 6

how do you confirm the diagnosis of a head and neck cancer?

Answer 6

Panendoscopy & Biopsy:

Direct Laryngoscopy, Tracheoscopy, Oesophagoscopy

Performed under general anaesthesia

Question 7

what is the management to T1 or T2 laryngeal cancer?

Answer 7

transoral laser surgery
radiotherapy

Question 8

what is the management of advanced T3 or 4 laryngeal cancer?

Answer 8

partial or total laryngectomy
chemo and radiotherapy

Question 9

what is the treatment of T1 and 2 oropharyngeal cancer?

Answer 9

chemo-radiotherapy
transoral robotic surgery

Question 10

what is the treatment of T3 and 4 oropharyngeal cancer?

Answer 10

chemo-radiotherapy

Question 11

what is the treatment of nasopharyngeal cancer?

Answer 11

radiotherapy (and also chemo sometimes)

Question 12

what salivary gland is the most common to have tumours?

Answer 12

parotid

Question 13

what is the rising cause of oropharyngeal SCC?

Answer 13

HPV