head + neck cancer

Question 1

commonest site of H+N cancer

Answer 1

larynx

Question 2

commonest type of H+N cancer

Answer 2

squamous cell carcinoma

usually spread to lymph nodes first

Question 3

H+N cancer assoc with south china + EBV

Answer 3

nasopharyngeal carcinoma

Question 4

H+N cancer assoc with smoking + alcohol

Answer 4

laryngeal carcinoma

Question 5

H+N cancer assoc with HPV, in ‘West’

Answer 5

oropharyngeal carcinoma

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

Question 6

H+N cancer assoc with southern Asia and chewing tobacco

Answer 6

oral cavity carcinoma

Question 7

what length of dysphonia warrants an urgeny reffereal for laryngoscopy?

Answer 7

> 3weeks

Question 8

H+N cancer red flags

Answer 8

unexplained ulceration in mouth lasting >3weeks
persistent neck lump
unexplained hoarseness of voice
unexplained thyroid lump
erythroplakia or erythroleukoplakia
lump in mouth or lip

Question 9

management of laryngeal management

Answer 9

early - transoral laser surgery, radiotherapy

advanced - partial/total laryngectomy, chemo + radio

(neck nodes need either chemo-rafiotherapy or surgery to remove)

Question 10

oropharyngeal cancer management

Answer 10

early - transoral robotic surgery, chemo-radiotherapy

advanced - chemo + radio

Question 11

H+N cancer assoc with hard wood joiners

Answer 11

nasal cavity cancer

Question 12

commonest cause of neck lumps

Answer 12

lymph nodes

Question 13

posterior triangle swellings

Answer 13

cystic hygroma

lymph nodes

Question 14

carotid body tumours

Answer 14

contains glomus cells, groups of glomus = paraganglia (paragangliomas)

upper anterior triangle(near mandible)
painless, pulsatile, assoc bruit
mobile side to side but not up n down