Head and Neck Disorders

Question 1

Benign “mass” in the SCM of the neck, causes the mastoid to be pulled down towards the clavicle and sternum

The chin is turned towards the opposite shoulder and the shoulder on the affected side is raised

Answer 1

Torticollis

Question 2

What disorder’s presentation is described below?

SCM mass

SCM tight, hard band

Resisted passive rotation of head ipsilaterally

Non-tender fusiform swelling

Answer 2

Torticollis

Question 3

Remnants from the embryological development of the primitive neck

These are not midline and do not move with swallowing

Soft, cystic masses

Answer 3

Branchial Cleft Cysts

Question 4

Remnant occurring along the embryologic descent of the thyroid

Midline 90% of the time

Will move with swallowing and tongue protrusion

Most common before age 20

Answer 4

Thyroglossal Duct Cyst

Question 5

Inflammatory masses of the head and neck are most commonly caused by which organisms?

Answer 5

Staph aureus

Group A strep

Mouth anaerobes

More commonly mixed with B-lactamase production

Question 6

Single most common neck mass at any age

May persist longer than the underlying cause

If greater than 40, rule out malignancy

Pathogenesis = widespread!

Treatment- treat the underlying cause

Answer 6

Reactive Lymphadenopathy

Question 7

What are some causes of granulomatous neck masses?

Answer 7

Catch scratch disease (Bartonella henselae)
Sarcoidosis
Mycobacterial adenitis (scrofula)

Question 8

The head and neck can be a common location for non-malignant head masses - list a few examples.

Answer 8

Sebaceous cysts
Lipomas
Skin tags
Occipital
Pre/post auricular adenopathy

Question 9

Most malignant lesions of the head involve primary malignancies from what location(s)?

Answer 9

from the oral and nasopharynx

Question 10

The area is the site most often involved with lesions of metastatic disease is what?

Answer 10

lateral neck

Question 11

What are two major etiologic factors in malignant head masses?

Answer 11

Alcohol and tobacco

Question 12

What is another major etiologic factor that we are seeing more instances of in head and neck cancers occuring mainly in the oropharynx?

Answer 12

HPV

Question 13

What is the predominant type of malignant head masses we see?

Answer 13

Squamous cell carcinoma

Question 14

What is the most common neoplasm to metastasize to the lymph nodes?

Answer 14

Squamous cell carcinoma

Question 15

What are the most common squamous cell carcinoma primary locations in the head and neck?

Answer 15

Most frequent are the tongue, tonsils, larynx (85%)

Question 16

This malignant head mass may not present as typical mass

Nodules may be rubbery, especially in a young adult or AIDs
patient (multiple, non-tender)

Papular lesions on the face and scalp

10% present in head and neck

Answer 16

Lymphoma

Question 17

Group of cancers that affect young 20 year old adults and 50 year old age groups

May present as a painless neck mass or loss of neck ROM

Non-surgical disease

Answer 17

Hodgkin’s Disease