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ENT Medicine > Head and Neck Seminar > Flashcards

Head and Neck Seminar Flashcards

1
Q

How common are head and neck cancers in the uk?

A

4th most common cancer in men, 13th most common cancer in women

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2
Q

Where is the most common site for head and neck cancer?

A

Larynx

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3
Q

What is the 5 year survival for head and neck cancer?

A

28-67% survival depending on stage

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4
Q

What is the most common cancer in type of head and neck cancer?

A

Squamous cell carcinoma

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5
Q

What part of the world are nasopharyngeal carcinomas common in?

A

South China = related to EBV, present with hearing problems

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6
Q

What is laryngeal carcinoma related to?

A

Cigarettes and alcohol

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7
Q

What is oropharyngeal carcinoma associated with?

A

HPV

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8
Q

Where are oral cavity carcinomas common in the world?

A

Southern Asia = associated with chewing tobacco

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9
Q

What is the stereotypical head and neck cancer patient?

A

Male, over 55, long exposure to cigarettes and alcohol

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10
Q

What are the risk factors for head and neck cancer?

A

Tobacco, HPV, alcohol, betel nut, EBV, hardwood

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11
Q

What is the typical patient for oropharyngeal carcinoma related to HPV?

A

Non-smoker, higher socio-economic class, multiple sexual partners

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12
Q

What are the presenting symptoms of head and neck cancer?

A 
Dysphonia >3 weeks (urgent referral for laryngoscopy)
Dysphasia (usually progressive)
Odynophagia
Unilateral Otalgia
Neck lump = painless and progressive
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13
Q

Where do supraglottic tumours drain to?

A

Superior deep cervical nodes

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14
Q

Where do glottis tumours present?

A

On the vocal cords = 95% stay there as minimal lymphatic drainage

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15
Q

What are the symptoms of glottic and subglottic tumours?

A

Voice change and airway obstruction

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16
Q

Where do subglottic tumours spread to?

A

Paratracheal nodes

17
Q

Where do oral cancers tend to present?

A

On lateral tongue borders

18
Q

Where are pleomorphic adenomas common?

A

In parotid glands

19
Q

Are blood tests usually done to investigate head and neck cancer?

A

No = they are of little value

20
Q

What imaging techniques are used in diagnosis?

A 
MRI = good for viewing soft tissues 
US = good for nodes
CT = CT of chest for staging
21
Q

What are biopsy and parendoscopy used for?

A

Confirming diagnosis

22
Q

What are some investigations that require general anaesthetic?

A

Direct laryngoscopy, tracheoscopy, oesophagoscopy

23
Q

What imaging techniques are used for staging?

A 
CT = good for nodes and larynx
MRI = nasopharynx and tongue base
24
Q

How is laryngeal carcinoma treated?

A 
T1/T2 = transoral laser surgery, radiotherapy 
T3/T4 = partial or total laryngectomy, chemo/radiotherapy
25
Q

How are neck nodes treated?

A

Chemo/radiotherapy, surgery

26
Q

What are some features of a total laryngectomy?

A

Often curative, morbidity significant

27
Q

What is the management of oropharyngeal carcinoma?

A 
T1/T2 = chemo/radiotherapy, transoral surgery 
T3/T4 = chemo/radiotherapy
28
Q

What is the 5 year survival for laryngeal and oropharyngeal carcinomas?

A

> 90%

29
Q

What are the symptoms of nasopharyngeal carcinoma?

A

30-40% have unilateral ear symptoms, up to 50% have nasal symptoms, up to 70% have palpable lymphadenopathy

30
Q

What nerves may be involved in nasopharyngeal carcinoma?

A

CN III, IV, V

31
Q

What is the treatment for nasopharyngeal carcinoma?

A

Radiotherapy

32
Q

What is the 5 year survival for nasopharyngeal carcinoma?

A

Stage 1 = 100%

Stage 4a = 67%

33
Q

What are masses in the parotid gland likely to be?

A

Benign (60%) = of these about 60% are pleomorphic adenomas

34
Q

What are tumours in the submandibular and sublingual glands likely to be?

A

Malignant

35
Q

What structures must be taken care of when carrying out a superficial or total parotidectomy?

A

Facial nerve, retromandibular vein, external carotid artery

ENT Medicine (22 decks)

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