Neck Masses

Question 1

Example of COngenital Neck Masses

Answer 1

Thyroglossal duct cyst
Branchial cleft cyst
Cystic hygroma

Question 2

_______is located on the midline, at the level of the hyoid bone, and originates
from the foramen cecum in the tongue (pulling at the tongue retracts the mass).

Answer 2

Thyroglossal duct cyst i

Question 3

MX of Thyroglossal duct cyst i

Answer 3

Surgical removal includes the cyst, the middle segment of the hyoid bone, and the track that leads to the base of the tongue (Sistrunk procedure

Question 4

_______ occurs laterally, along the anterior edge of the sternomastoid muscle, anywhere
from in front of the tragus to the base of the neck

Answer 4

Branchial cleft cyst

Question 5

________ is found at the base of the neck as a large, mushy, ill-defined mass that occupies
the entire supraclavicular area and seems to extend deeper into the chest.

Answer 5

Cystic hygroma

Question 6

What is needed before removal of Cystic hygroma

Answer 6

often extends

into the mediastinum, and therefore CT scan before attempted surgical removal is mandatory

Question 7

________ is typically seen in young people; they often have multiple enlarged nodes (in the neck and elsewhere) and have been suffering from low-grade fever and night
sweats.

Answer 7

Lymphoma

Question 8

Metastatic tumor to________invariably comes from below the clavicles (and not from the head and neck)

Answer 8

supraclavicular nodes

Question 9

________of the mucosae of the head and neck is seen in older men who smoke, drink, and have rotten teeth. Patients with AIDS are also prime candidates

Answer 9

Squamous cell carcinoma

Question 10

Dxtic for Squamous cell carcinoma

Answer 10

The ideal diagnostic workup is a triple endoscopy (or panendoscopy) looking for the primary tumor.

Question 11

T or F

FNA of the node may be done, but open biopsy of the neck mass should never be performed, as an incision in the neck will eventually interfere with the appropriate
surgical approach for the tumor.

Answer 11

T

Question 12

Mx for Squamous cell carcinoma

Answer 12

Treatment involves resection, radical neck dissection, and very often radiotherapy and platinum-based chemotherapy

Question 13

_______ are visible and palpable in front of the ear, or around the angle of the mandible

Answer 13

Parotid tumors

Question 14

MC Parotid tumors

Answer 14

Most are pleomorphic adenomas, which are benign but have potential for malignant degeneration.

Question 15

A hard parotid mass that is painful or has produced paralysis is a______

Answer 15

parotid cancer

Question 16

Dx of parotid tumors

Answer 16

FNA of these tumors may be done, but open biopsy is absolutely contraindicated

Question 17

Mx of parotid cancer

Answer 17

A formal superficial parotidectomy (or superficial and deep if the tumor is deep to the
facial nerve) is the appropriate way to excise—and thereby biopsy—parotid tumors,
preventing recurrences and sparing the facial nerve

Question 18

Mx of foreign body ingestion

Answer 18

The appropriate endoscopy under anesthesia will allow extraction.

Question 19

_______is an abscess of the floor of the mouth, often the result of a bad tooth infection

Answer 19

Ludwig’s angina

Question 20

Mx of Ludwig’s angina

Answer 20

Incision and drainage are done, but intubation and tracheostomy may also be needed
to protect the airway

Question 21

Epistaxis in children is typically from nosepicking; the bleeding comes from the ______
and phenylephrine spray and local pressure controls the problem

Answer 21

anterior septum,

Question 22

In teenagers the prime suspects for epistaxis are _______ and _______

Answer 22

cocaine abuse (with septal perforation) or juvenile nasopharyngeal angiofibroma.

Question 23

Mx of epistaxis

Answer 23

posterior packing

Question 24

A successful sympathetic block is diagnostic, and surgical sympathectomy is curative

Answer 24

Reflex sympathetic dystrophy (causalgia)