Head & 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 & oral cavity:
A
Orfacial clefts
3
Q
Defective fusion with the medial nasal process and maxillary process:
A
Cleft lip
4
Q
Cleft lip occurs due to defect fusion of:
A
Medial nasal process & 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: 35%
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
- anticonvulsant therapy (Phenytoin: 10x risk!)
11
Q
What supplement may be a prevention to orofacial clefts?
A
Folic acid
12
Q
Orofacial cleft that extends upward into the nostril:
A
Complete CL
13
Q
Orofacial cleft that does not involves the nose:
A
incomplete CL
14
Q
Orofacial cleft that may involve hard & soft palate:
A
Cleft palate
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 includes:
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:
-B/L & symmetrical fistulas on either side of the midline of lower lip
-subtle depression or prominent bulge
-Van der Woude syndrome
A
Paramedian lip pits
21
Q
Van der Woude syndrome (seen in Paramedian lip pits) is characterized by:
A
lip pits with cleft lip & or cleft palate
22
Q
Most common form of syndromic clefting:
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 papulate
-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 a ____ cause
common; unknown
28
Clinical features:
-diffuse, gray-white color
-folded, wrinkled mucosa
-B/L 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 & 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, hemihyperplasia, & down syndrome:
Congenital macroglossia
36
Form of macroglossia characterized by edentulous patients, amyloidosis, & myxedema:
Acquired macroglossia
37
What form of macroglossia is most common in patients with Down syndrome:
Congenital
38
AKA tongue-tie:
Ankyloglossia
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 descends into:
neck- anterior to trachea
43
When the primitive thyroid gland does not descend normally & ectopic thyroid tissue is found between foramen cecum & 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 but large may = airway blockage, dysphagia, dyspnea
-hypothyroidism (33%)
Lingual thyroid
46
Small amounts of ectopic thyroid tissue (lingual thyroid) may be ______ however 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 a lingual thyroid?
excisional 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
-2-6mm in depth
-usually asymptomatic
-strong association with geographic tongue
Fissured tongue
52
Treatment for fissured tongue include:
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 tongue 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, or black)
-patient may complain of bad taste
Hairy tongue
57
Treatment of hairy tongue:
1. eliminate predisposing factors (i.e. tobacco)
2. oral hygiene
58
Abnormally dilated tortuous veins:
Varicosites
59
Varicosities can be described as a ____ process
Age-related degenerative
60
Clinical features:
-sublingual varicosities (2/3 of people above age 60)
-blue-purple elevated papular blebs (ventral + lateral tongue)
-may also occur on the lips & buccal mucosa
-usually asymptomatic
Varicosities
61
Treatment of varicosities:
Sublingual varicosities - none
Solitary varicosisites (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 & 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 getting dentures presents with exostosis what needs to occur?
surgical removal
67
Bony hard nodule of midline suture of hard palate:
torus palatinus
68
What sex & population is torus palatinus most common in?
Females 2:1
Asian + Inuit
69
Treatment of torus palatines:
Deciding clinically whether treatment (surgical excision) needs to be performed
70
Clinical + radiographic features:
-bony hard nodule on lingual aspect of mandible
-90% B/L involvement
-most common in premolar region
-most common in asian & Inuit population
-Radiographically: bony nodule superimposed on teeth
Torus mandibularis
71
Torus mandibularis is most common in what location of the oral cavity? Most common in what population?
Premolar region; asian & 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 defect most commonly occurs in:
males (80-90%)
76
Radiograpic features:
-Radiolucency below the mandibular canal
-Lingual cortical defect
-occasionally may occur anteriorly
-well circumscribed with sclerotic border
-usually remains static over time
-asymptomatic
Stafne defect
77
Treatment for stafne defect:
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 & embryogenesis
80
Clinical features:
-common, may occur in 55-85% of newborns
-most along the midline of hard & soft palate
-appear as small white or yellow-white papules on palate
-cysts are 1-3mm and filled with keratin
Palatal cyst 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 cyst arises from:
remnants of nasopalatine duct
84
Nasopalatine duct cysts are most common in the:
4th-6th decade of life (especially in males)
85
Clinical features:
-may exhibit swelling of anterior palate
-drainage
-occasionally painful
-1-2.5 cm in diameter
Nasopalatine duct cyst
86
Radiographic features:
-Well-circumscribed radiolucency near midline of anterior maxilla 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 nasopalatin duct cyst:
surgical enucleation
89
Common cyst of the skin, arises from the hair follicle:
Epidermoid cyst of the skin
90
Account for 80% of follicular cysts 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
-unusually 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 structures 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 & testes
99
Head & neck dermoid cysts are most common in _____ at _____
Children & young adults at midline FOM
100
Describe a dermoid cyst in children & young adults:
Soft, doughy 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, movable swelling
-usually asymptomatic
Thyroglossal duct cyst
104
Treatment for thyroglossal duct cyst:
surgical excision
105
Developmental cyst that develops from the branchial arch remnants:
Branchial cleft cyst
106
Clinical features:
-located in the upper lateral neck anterior or deep to SCM
-develop in young children & adults
-soft fluctuant mass (1-10cm 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 & anterior tonsillar pillar
-firm or soft to palpation
-keratin in lumen
-often white or yellow
-usually asymptomatic
Lymphoepithelial cyst
110
Treatment of lymphoepithelial cyst:
1. Surgical excision should NOT occur
2. if distinctive biopsy is NOT necessary
111
Cleft palate
112
Cleft palate + cleft lip
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
Varicosities
128
What papilla are involve in hairy tongue?
Filiform
129
Varicosities
130
Exososis
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
