Oral Cancer and salivary glands Flashcards
Most common mutated gene in oral cancer
p53
Verrucous carcinoma
AKA Ackerman tumor
Slow growing tumor associated with HPV good prognosis
Difference between Candidiasis and leukoplakia
Candidiasis can not be rubbed off
Leukoplakia can be rubbed off
Which kind of leukoplakia has highest risk of malignancy
Specked leukoplakia
What is the management of oral submucous fibrosis?
Intralesional triamcinolone (also used in keloid costochondritis and ganglion)
What if antioxidant management fail in leukoplakia and candidiasis patient
CO2 laser excision / cautery
PV syndrome is AKA
Patterson, Kelly Brown syndrome
Syderopenic dysphagia
MC site for metastasis
Lung
What is commando procedure?
WLE + Neck dissection + Mandibulectomy
Deltopectoral flap use based on the perforator of
Internal mammary artery
PMMC flap based on the pectoral branch of the
Thoracoacromial vessel
Abbe estlander flap/ lip switch flap is use as the
Angle of mouth reconstruction
Circumoral advancement flap is also known as
Karpandazic flap
Which flap is most commonly used for mandibular reconstruction
Free fibular flap ( based on peroneal vessels )
Which flap is used for dentate mandible
Iliac crest flap(based on the deep circumflex iliac artery )
Management of lip cancer in less than 1/3 of area
Resection and primary closure
Management of lip cancer in 1/3to 2/3 area
Johansson / stepladder approach
Management of lip cancer in greater than 2/3 of area
Flap(Abbe estlander)
Buccal mucosal tumor management approaches
Intraoral approach,
lip slit approach
Visor approach
Weber freguson apprpach (for maxillectomy)
What is the most common prognostic factors for oral cancers?
Cervical lymph node status 
Thyroid and laryngeal cancer, first train to which lymph node
VI
Which incision is made in the
neck dissection ?
Modified schoebinger incision
Which structures are removed in RND ?
Level I to V LN are removed + three extra lymphatic structure are removed
Internal jugular vein,
spinal accessory nerve sternocleidomastoid muscle
Which structures are removed in MRND ?
Level I to V LN are removed + but at least one extra lymphatic structure is saved
MRND I ; spinal accessory nerve is saved
MRND II ; both spinal accessory nerve and Internal jugular vein saved
MRND III : all 3 saved (functional neck, dissection)
SND includes
CND (level VI remove; thyroid cancer)
SOHND (I,II,III Removed)
Extended SOHND (level I to IV removed )
How to prevent injury to marginal mandibular nerve/Ramus mandibularis
Incision should be at least two finger breadths below angle of mandible
What is dentigerous cyst ?
A cyst in relationship to an unerupted tooth
Most commonly involved teeth in dentigerous cyst is
3rd Molar
Diagnosis of ameloblastoma is made by
X-ray/OPG (orthopentagram)
Name blind areas where tumor can be missed
The oral pharyngeal and nasal pharyngeal region
floor of the mouth
retromolar trigone
tonsillar fascia,
pyriform sinus
Fossa of rosenMuller
What is Stafne bone cyst
Itis the most common site for ectopic salivary tissue
It is cyst in mandible
What is ranula?
A.k.a. frog belly,
Ranula is mucus extravasation cyst involving the sublingual salivary gland. It is a cystic swelling in the floor of the mouth
fluctuation & transillumination are positive.
What is contraindicated in management of ranula?
I & D
Most common structure, injured in surgery of salivary glands disease
Submandibular duct
Most common nerve , injured in surgery of salivary glands disease
Lingual nerve
What is plunging ranula?
Mucus retention cyst ( involving sublingual and submandibular gland)
Which management is used in parotid abscess?
Incision and drainage using Hiltons method
Which sign is seen an x-ray of a patient presents with the recurrent parotitis
Snowstorm appearance
Which sign is Sinon images of a patient presents with HIV parotitis
Swiss cheese appearance
What is Kuttner’s tumor
Chronic sclerosing Sialadenitis involving submandibular gland
What is sialoloithiasis?
Stone formation in the salivary glands
sialoloithiasis is more common in
Submandibular glands > parotid gland
in sialoloithiasis most common composition is
Calcium phosphate, 80% Stone are radio opaque
What is the meal time syndrome
Painful postprandial, neck swelling lasting 1 to 2 hours
The most common structure, injured in submandibular gland, stone surgery
Lingual Nerve
Most common benign tumor of salivary gland
Pleomorphic adenoma
Most common benign tumor of salivary gland in children
Hemangioma
Most common malignant salivary gland tumor
Mucoepidermoid cancer
What is the second most common malignant salivary gland tumor
Adenoid cystic cancer
What is the most common bilateral parotid tumor ?
Warthin tumor
What is the IOC for pleomorphic adenoma?
FNAC
Which gene mutation is responsible for pleomorphic adenoma
PLAG 1 gene
What is BLEL
Caused by CMV
Also called Godwin tumor
If it undergoes malignant changes, it is called eskimoma
Management : excision
Which gene fusion is responsible for mucoepidermoid cancer
CRTCI-MAML2 gene fusion
Which incision is made in parotid surgery
Lazy Z incision / modified Blair incision
 What to do if facial nerve is sacrificed (like in total radical parotidectomy)
A cable graft is used to bridge the gap best nerve used for this is the Sural Nerve
Most commonly used is the greater auricular nerve
Most important pointer for the facial nerve injury
It is 1 cm inferior in deep to the tragal pointer/ conley pointer
Which nerve is implicated in the frey’s syndrome / gustatory sweating / dupuy syndrome/ auriculotemporal syndrome
Auriculotemporal nerve
How does parotid fistula of the duct is managed
By Newman and Seabrook surgical procedure
Most common tumor of submandibular gland
Pleomorphic adenoma
Most common malignant tumor of submandibular gland
Adenoid, cystic, carcinoma
Most common sublingual tumor
Adenoid cystic cancer
Most common theme of minor salivary gland
Adenoid cystic carcinoma
MC site ; hard palate
Symptoms if intercoastobrachial nerve is injured
Anesthesia in axilla post MRM
Symptoms if greater auricular nerve is injured
Anesthesia while shaving
Seen in post parotidectomy
Symptoms of spinal accessory nerve is injured
Shoulder dysfunction after neck dissection
Symptoms if Iliohypogastric nerve is injured
Chronic inguinal pain after open inguinal hernia surgery
Symptoms if marginal mandibular now is injured
Drooping of angle of mouth
Structures which are injured in submandibular gland, surgery
Marginal, mandibular nerve
Lingual nerve
Hypoglossal nerve
Anterior facial nerve
Facial artery
In submandibular gland, stones stones proximal to the lingual nerve retrieve via
Intraoral surgical approach
Most common site of branchial cyst is
Junction of the upper and middle third of the SCM
