Head and Neck Developmental Disorders: Flashcards
1
Q
One of the most common major congenital defects:
A
Orofacial clefts
2
Q
results from disturbances in growth of face and oral cavity:
A
orofacial clefts
3
Q
Defective fusion with the medial nasal process & maxillary process:
A
Cleft Lip
4
Q
Cleft Lip occurs due to defective fusion of:
A
Medial nasal process and Maxillary process
5
Q
Failure of the palatal shelves to fuse:
A
Cleft palate
6
Q
A cleft palate occurs due to failure of fusion of the:
A
palatal shelves
7
Q
- Cleft lip + Cleft Palate:
- Cleft palate only:
- Cleft lip only:
A
- Cleft lip + Cleft Palate: 45%
- Cleft palate only: 30%
- Cleft lip only: 25%
8
Q
Orofacial clefts are most common in what population?
A
Native Americans and asians
9
Q
Causes and risk factors for orofacial clefts include:
A
- genetic factors (syndromic)
- environmental factors
10
Q
What environmental factors are associated with orofacial cleft risk?
A
- maternal alcohol & tobacco
- anti-convulsent therapy (phenytoin): 10x risk!!
11
Q
What supplement may be prevention to orofacial clefts?
A
Folic acid
12
Q
orofacial cleft that extends up into the nostril:
A
Complete CL
13
Q
Orofacial cleft that does not involve the nose:
A
Incomplete CL
14
Q
Orofacial cleft that may involve hard and soft palate:
A
CP
15
Q
A minimal manifestation of orofacial clefts:
A
bifid uvula
16
Q
Orofacial clefts may interfere with teeth development such as:
A
- hypodontia
- malformed teeth
- bony defects
- malocclusion
17
Q
Treatment of orofacial clefts include:
A
- multidisciplinary approach
- surgical treatment
- prosthetic appliances
18
Q
Congenital invaginations of the lower lip:
A
Paramedian lip pits
19
Q
Paramedian lip pits inheritance pattern:
A
autosomal dominant
20
Q
Clinical features:
- bilateral and symmetrical fistulas on either side of midline of lower lip
- subtle depression or prominent bulge
- Van der Woude syndrome
A
Paramedian lip pits
21
Q
Van De Woude Syndrome seen in Paramedian lip pits is characterized by:
A
lip pits with cleft lip and/or cleft palate
22
Q
Most common form of syndromic cleftng:
A
Van Der Woude Syndrome
23
Q
Treatment of Paramedian lip pits includes:
A
None (except for cosmetic reasons)
24
Q
Ectopic sebaceous glands in oral mucosa:
A
Fordyce granules
25
Clinical features:
- multiple yellow or yellow-white papules
- common on the buccal mucosa, vermillion of upper lip, retromolar pad, tonsillar area
Fordyce granules
26
Treatment of fordyce granules:
none
27
Leukoedema is a ___ condition with an ____ cause
common; unknown
28
Clinical features:
- diffuse gray-white color
- folded, wrinkled mucosa
- bilateral buccal mucosa
- white appearance that disappears when mucosa is stretched
Leukoedema
29
Treatment for leukoedema:
none
30
T/F: Microglossia is a common developmental condition:
false- rare
31
Clinical features:
- abnormally small tongue
- may be associated with a syndrome
microglossia
32
Treatment of microglossia:
1. depends on nature and severity
2. surgery and orthodontics
33
Enlargement of tongue:
macroglossia
34
T/F: Macroglossia is primarily associated with one condition
False- may be caused by a variety of conditions
35
Form of macroglossia characterized by vascular malformations, lymphangioma, hemihyerplasia, and Down syndrome:
Congenital macroglossia
36
Form of macroglossia characterized by edentulous patients, amyloidosis, and myxedema:
Acquired macroglossia
37
What form of macroglossia is most common in Down syndrome individuals?
Congenital
38
AKA: tongue tie
Ankyglossia
39
Developmental anomaly of the tongue:
ankyloglossia
40
Clinical features:
- short thick frenum
- may result in speech defects
- breastfeeding difficulties
Ankyloglossia (tongue-tie)
41
Treatment for Ankyloglossia (tongue-tie):
Frenectomy for functional problems
42
Typically, the thyroid bud decent into:
Neck anterior to trachea
43
When the primitive thyroid gland does not descend normally, and ectopic thyroid tissue is found between foramen cecum and epiglottis:
Lingual thyroid
44
Where is ectopic thyroid tissue found in the case of "lingual thyroid"?
between foramen cecum & epiglottis
45
Clinical features:
- most common in females (4x) due to hormonal influences
- Ectopic gland (70%) is often only thyroid tissue
- ranges in size (small= asymptomatic) (large may = airway blockage, dysphagia, and dyspnea)
- Hypothyroidism (33%)
Lingual thyroid
46
Small amounts of ectopic thyroid tissue (lingual thyroid) may be ____.
Large amounts of ectopic thyroid tissue may ____ causing ____ or ____.
asymptomatic
block airway; dysphagia; dyspnea
47
How would you diagnose a lingual thyroid?
Thyroid scan
48
What would you want to avoid with diagnosis of lingual thyroid?
excisionial biopsy- as this may be the patients only thyroid tissue
49
Treatment of lingual thyroid:
1. periodic follow up
2. thyroid hormone replacement
50
A fissured tongue is often ____ but may also be a ____.
hereditary; degenerative process
51
Clinical features
- dorsal surface grooves, furrows
- 2-6 mm in depth
- usually asymptomatic
- strong association with geographic tongue
Fissured tongue
52
Treatment for fissured tongue includes:
None- encourage good oral hygeine
53
Marked elongation of filiform papillae due to keratin accumulation:
Hairy tongue
54
Hairy tongue is due to ____ accumulation
keratin
55
Risk factors for hairy include: (5)
1. smoking
2. poor oral hygiene
3. general debilitation
4. radiation therapy
5. medications
56
Clinical features:
- dorsal tongue
- elongated papillae (usually brown, yellow, black)
- patients may complain of bad taste
Hairy tongue
57
Treatment for hairy tongue:
1. eliminate predisposing factors (i.e. tobacco)
2. oral hygiene
58
Abnormally dilated tortuous veins:
varicosities
59
Varicosities can be described as a ___ process
Age-related degenerative
60
Clinical features:
- sublingual varicosities (2/3 of ppl above age 60)
- Blue-purple, elevated papular blebs (ventral + lateral tongue)
- may also occur on the lips and buccal mucosa
- usually asymptomatic
Varicosites
61
Treatment of varicosities:
sublingual varicosities: none
Solitary varicosities (other locations) may need excision to confirm diagnosis
62
Localized bony protuberances arising from cortical plate:
Exostosis
63
Exostosis may be related to:
stresses from teeth
64
Clinical features
- observed in adults
- occur in the buccal and palatal regions
- may be tooth-stress related
exostosis
65
Treatment of exostosis:
1. distinctive clinically decide whether it needs treatment or not
66
If a patient with a denture has exostosis what needs to occur?
surgical removal
67
Bony hard nodule of midline suture of hard palate:
torus palatinus
68
What sex and population is torus palatines most common in?
Females (2:1)
Asian + Inuit
69
Treatment of torus palitinus:
Deciding clinically where surgical excision is necessary
70
Clinical/ radiographie features:
- body hard nodule on lingual aspect of mandible
- 90% bilateral involvement
- most common in premolar region
- most common in asian and Inuit people
- RG: bony nodule superimposed on teeth
Torus mandibularis
71
Torus mandibularus is most common in what location of the oral cavity? Most in what population?
premolar region- asians and inuit people
72
How does torus mandibularis appear radiographically?
bony nodule superimposed on teeth
73
Developmental defect in mandibular alveolar bone:
stafne defect
74
The developmental defect seen in stafne defect may contain:
normal salivary gland tissue
75
Stafne affect most commonly occurs in:
males (80-90%)
76
Radiographic features:
- radiolucency below the mandibular canal
- lingual corticol defect
- occasionally may occur anteriorly
- well circumscribed with sclerotic border
- usually remains static over time
- asymptomatic
Stafne defect
77
Treatment for stafne defect includes:
none
78
Small developmental cysts on palate of newborn
Palatal cyst of the newborn
79
Palatal cyst of the newborn may result from:
trapped epithelium during palatal fusion in embryogenesis
80
Clinical feature:
- common (may occur in 55-85% of newborns)
- most along the midline of hard and soft palate
- appears as small white or yellow-white papule on palate
- 1-3 mm keratin filled cysts
Palatal cysts of the newborn
81
Treatment of palatal cyst of the newborn:
None
82
Most common developmental non-odontogenic cyst:
Nasopalatine duct cyst
83
The nasopalatine duct cysts arises from:
remnants of nasopalatine duct
84
Nasopalatine duct cysts are most common in the:
4th-6th decade of life (esp. in males)
85
Clinical features:
- may exhibit swelling of anterior palate
- occasionally painful
- drainage
- 1-2.5cm in diameter
Nasopalatine duct cyst
86
Radiographic features:
- well-circumscribed
- radiolucency near midline of anterior maxillary apical to central incisors
- may be difficult to distinguish small cyst from large incisive foramen
Nasopalatine duct cyst
87
What may be difficult to distinguish from large incisive foramen?
Nasopalatine duct cyst
88
Treatment of nasopalatine duct cyst:
surgical enucleation
89
Common cyst of the skin that arises from the hair follicle:
epidermoid cyst of the skin
90
Account for 80% of follicular cyst of the skin:
Epidermoid cyst of the skin
91
clinical features:
- common in acne prone regions
- common areas: scalp, face, back
- Nodular fluctuant subcutaneous swelling
- Unusual before puberty unless associated with Gardner syndrome
Epidermoid cyst of the skin
92
Epidermoid cyst of the skin is unusual before puberty unless:
associated with Gardner syndrome
93
Treatment of Epidermoid cyst of the skin:
Conservative enucleation
94
Developmental cystic malformation:
dermoid cyst
95
Lined by epidermis with dermal adnexal structure within cyst wall:
Dermoid cyst
96
Benign cystic form of a teratoma:
Dermoid cyst
97
Developmental tumor composed of more than one germ layer (ectoderm, mesoderm, endoderm)
Teratoma
98
Teratomas are most common in the:
Ovaries and testes
99
Head and neck dermoid cysts are most common in ___ @ ____
children and young adults; midline FOM
100
Describe a dermoid cyst in children and young adults:
soft bony mass - may produce submental swelling
101
Treatment of dermoid cyst:
surgical excision
102
Arises from thyroglossal duct remnants that normally undergo atrophy:
Thyroglossal duct cyst
103
Clinical features:
- develop from foramen cecum to suprasternal notch
- 60-80% develop adjacent to hyoid bone
- 50% of these are diagnosed by age 20
- fluctuant, moveable swelling
- usually asymptomatic
thyroglossal duct cyst
104
Treatment for a thyroglossal duct cyst:
surgical excision
105
Developmental cyst that develops from branchial arch remnants:
Branchial cleft cyst
106
Clinical features:
- located in the upper lateral neck anterior or deep SCM
- Develop in young children and adults
- soft, fluctuant mass, 1-10 cm in diameter
Branchial cleft cyst
107
Treatment of branchial cleft cyst:
Surgical excision
108
Lesion that develops from oral lymphoid tissue:
Lymphoepithelial cyst
109
Clinical features:
- small submucosal mass (usually less than 1cm)
- common on posterior lateral tongue, and anterior tonsillar pillar
- firm or soft to palpation
- often white or yellow: keratin in lumen
- Usually asymptomatic
Lymphoepithelial cyst
110
Treatment of lymphoepithelial cyst:
- Surgical excision should NOT occur
- If distinctive a biopsy is NOT necessary
111
Cleft palate
112
Cleft lip + Cleft Palate
113
Bifid Uvula
114
paramedian lip pits
115
fordyce granules
116
Leukoedema
117
Leukoedema
118
Microglossia
119
Macroglossia
120
macroglossia
121
Ankyloglossia (Tongue tie)
122
Ankyloglossia (Tongue tie)
123
lingual thyroid
124
fissured tongue
125
Hairy tongue
126
Hairy tongue
127
What papillae are involved in hairy tongue:
filiform
128
varicosities
129
varicosities
130
exostoses
131
torus mandibularis
132
torus mandibularis
133
stafne defect
134
palatal cyst of newborn
135
nasopalatine duct cyst
136
nasopalatine duct cyst
137
epidermoid cyst of the skin
138
dermoid cyst
139
dermoid cyst
140
dermoid cyst
141
branchial duct cyst
142
lymphoepithelial cyst
143
lymphoepithelial cyst
144
lymphoepithelial cyst
