HEAD & NECK TUMOURS

Question 1

Region described from the ___________ to the _________________.

• excludes tumours of the ___________ contents and tumours of the ___________ and ___________

Answer 1

cranium ; base of the neck.

intracranial

globe and orbit

Question 2

Head and neck tumors

Constitutes ____% of all cancers
Approx 500,000 cases diagnosed annually Approx. 300,000 deaths worldwide
Male : Female ___:____

Answer 2

3-5

2:1

Question 3

Head and neck tumors Can be
- __________ , __________ or __________
- __________ and __________ tumours.

Answer 3

Can be
- benign, intermediate or malignant
- Epithelial and non-epithelial tumours.

Question 4

Generally –
Benign:
*___________
* ___________
* ___________
* ___________
*Fibroma/angiofibromas
*mixed

Answer 4

*Papillomas
*Adenomas
*Chondromas
*Neuromas
*Fibroma/angiofibromas
*mixed

Question 5

Generally:-

Malignant:
* ____________ carcinoma
* ____________
* ________carcinoma/Adenocystic Ca.
* ____________/____________/____________ Ca.
*Melanomas
* ________Cell Carcinoma
*Neuroblastoma

Answer 5

Malignant:
* Squamous cell carcinoma
*Lymphoma
*Adenocarcinoma/Adenocystic Ca. *Papillary/Medullary/Follicular Ca.
*Melanomas
*Basal Cell Carcinoma
*Neuroblastoma

Question 6

Generally:-

Intermediate: *_____________
*Ameloblastoma
* Chemodectomas

Answer 6

Inverted papilloma

Question 7

Manifestations of head and neck tumors
- Dependent on _____________
- _____________ enlargement
- _________ in affected areas
- Signs of _____________

Answer 7

Manifestations
- Dependent on the site affected
- Lymph node enlargement
- Pain in affected areas
- Signs of metastasis

Question 8

Larynx
‘Voice box’

Males: female ratio : ____:___
Risk Factors –________,_______ , __________ lesion- laryngeal papilloma, previous ________, long standing __________

Answer 8

1-7:1

smoking , alcohol

pre- cancerous

irradiation; reflux laryngitis

Question 9

Diagnosis of laryngeal tumors= hx, exam + inv

Hoarseness- _________ and ___________
Noisy/difficulty in breathing/________ . Airway obstruction
Aspiration
Video Laryngoscopy - Vocal/supraglottic lesion
CT/MRI – extent of tumour + nodal met. Biopsy carried out commonly under G.A

Answer 9

progressive and unremitting

stridor

Question 10

Classification of laryngeal tumor - T N M
T1 – tumour is _____________, may involve ant. or post. Commissure with ___________
T2- Tumour extends to_______________ with impaired ___________
T3-Tumor limited to the _________ with __________
T4a- Tumor ________ the larynx.
T4b- encases _________, invades ____________

Answer 10

limited to the VC; normal mobility

supraglottic or subglottic; VC mobility

larynx with VC fixation

beyond

carotid; mediastinum

Question 11

Nodal classification
N1- ____lateral node <___cm
N2a- ____lateral node >___ but </=___cm
N2b-multiple _____lat. Nodes ______ >6cm
N2c- ______lateral node/——lateral nodes none >6cm
N3- Any node>6cm

Answer 11

ipsi;3

ipsi;3;6

ipsi; none

contra;bi

Question 12

Treatment of laryngeal tumor

Initial __________ for pt with airway obstruction.
Surgery – __________-total or partial, Partial- Vertical or Horizontal
Total- complete removal with a ____________________ , +/-speaking valve/voice prosthesis.
+/-Neck Dissection where there is nodal metastasis.
•___________

Answer 12

tracheostomy

Laryngectomy

permanent tracheostomy

Radiation

Question 13

Prognosis in laryngeal tumors

In early stages nearly _____% 5year survival rate
Late stages _______% 5 year survival.

Answer 13

100

30-45

Question 14

Nasopharyngeal tumour

Occur within the nasopharyngeal space Often from the __________________
Closely related to the ____________ and ____________ space
Anteriorly with the ____________
Superiorly -____________ (basi-sphenoid) Supero-laterally -____________
Inferiorly the -____________

Answer 14

fossa of Rossenmuller

eustachian tube ; parapharyngeal space

nasal cavity ; base of skull

orbit ; oropharynx

Question 15

Nasopharyngeal tumors

epidemiology
Occurs 1/100,000 per population
Most prevalent among the _________ and and people of _________ descent,
Higher among the _________ within the subregion
Higher among _________/_________ americans

Answer 15

Chinese ; asian

North africans

chinese/asian americans

Question 16

Risk Factors of nasopharyngeal tumors

_____ gender
Ingestion of ____________ meals and other nitrosamine containing diets
____________ of NPC
____________ infection
Genetic factors
Tobacco, Alcohol
Exposure to ____________

Answer 16

Male ; salted ungutted meals

Family hx ; Ebstein Barr Virus

wood dust

Question 17

Diagnosis of nasopharyngeal tumors- hx, exam
Nasal obstruction
__________
____________ hearing loss
Cervical lymphadenopathy
_________/_________/________
Nasoendoscopy &
Biopsy of nasopharyngeal mass for Histopathology

Answer 17

Epistaxis; Conductive

Proptosis; diolopia; headache

Question 18

Oropharyngeal tumor
Area bounded by
1. ________________ and the ____________
2. The ________ /________ fossae
3. Oropharyngeal surface of the soft palate and the oropharyngeal isthmus
4. Communicates inferiorly with the ________ and ________

Answer 18

Anterior faucial pillars ; base of the tongue

tonsil/tonsillar

larynx and hypopharynx

Question 19

Risks of Oropharynheal tumors

__________
Heavy _______ use
________ infection
Previous head and neck tumor
Previous _________ to the head and neck

Answer 19

Risks
Smoking
Heavy alcohol use
HPV 16 infection
Previous head and neck tumor
Previous radiation to the head and neck

Question 20

Sinonasal tumours
Tumours of the nose and paranasal sinuses
Constitutes <1% of all tumours
Late presentation/diagnosis due to non- specificity of early symptoms often taken for usual ‘_______’

Answer 20

catarrh