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Surgery > Oral Cancer and salivary glands > Flashcards

Oral Cancer and salivary glands Flashcards

1
Q

Most common mutated gene in oral cancer

A

p53

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2
Q

Verrucous carcinoma

A

AKA Ackerman tumor
Slow growing tumor associated with HPV good prognosis

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3
Q

Difference between Candidiasis and leukoplakia

A

Candidiasis can not be rubbed off
Leukoplakia can be rubbed off

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4
Q

Which kind of leukoplakia has highest risk of malignancy

A

Specked leukoplakia

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5
Q

What is the management of oral submucous fibrosis?

A

Intralesional triamcinolone (also used in keloid costochondritis and ganglion)

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6
Q

What if antioxidant management fail in leukoplakia and candidiasis patient

A

CO2 laser excision / cautery

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7
Q

PV syndrome is AKA

A

Patterson, Kelly Brown syndrome
Syderopenic dysphagia

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8
Q

MC site for metastasis

A

Lung

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9
Q

What is commando procedure?

A

WLE + Neck dissection + Mandibulectomy

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10
Q

Deltopectoral flap use based on the perforator of

A

Internal mammary artery

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11
Q

PMMC flap based on the pectoral branch of the

A

Thoracoacromial vessel

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12
Q

Abbe estlander flap/ lip switch flap is use as the

A

Angle of mouth reconstruction

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13
Q

Circumoral advancement flap is also known as

A

Karpandazic flap

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14
Q

Which flap is most commonly used for mandibular reconstruction

A

Free fibular flap ( based on peroneal vessels )

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15
Q

Which flap is used for dentate mandible

A

Iliac crest flap(based on the deep circumflex iliac artery )

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16
Q

Management of lip cancer in less than 1/3 of area

A

Resection and primary closure

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17
Q

Management of lip cancer in 1/3to 2/3 area

A

Johansson / stepladder approach

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18
Q

Management of lip cancer in greater than 2/3 of area

A

Flap(Abbe estlander)

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19
Q

Buccal mucosal tumor management approaches

A

Intraoral approach,
lip slit approach
Visor approach
Weber freguson apprpach (for maxillectomy)

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20
Q

What is the most common prognostic factors for oral cancers?

A

Cervical lymph node status 

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21
Q

Thyroid and laryngeal cancer, first train to which lymph node

A

VI

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22
Q

Which incision is made in the
neck dissection ?

A

Modified schoebinger incision

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23
Q

Which structures are removed in RND ?

A

Level I to V LN are removed + three extra lymphatic structure are removed
Internal jugular vein,
spinal accessory nerve sternocleidomastoid muscle

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24
Q

Which structures are removed in MRND ?

A

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)

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25
Q

SND includes

A

CND (level VI remove; thyroid cancer)
SOHND (I,II,III Removed)
Extended SOHND (level I to IV removed )

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26
Q

How to prevent injury to marginal mandibular nerve/Ramus mandibularis

A

Incision should be at least two finger breadths below angle of mandible

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27
Q

What is dentigerous cyst ?

A

A cyst in relationship to an unerupted tooth

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28
Q

Most commonly involved teeth in dentigerous cyst is

A

3rd Molar

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29
Q

Diagnosis of ameloblastoma is made by

A

X-ray/OPG (orthopentagram)

30
Q

Name blind areas where tumor can be missed

A

The oral pharyngeal and nasal pharyngeal region
floor of the mouth
retromolar trigone
tonsillar fascia,
pyriform sinus
Fossa of rosenMuller

31
Q

What is Stafne bone cyst

A

Itis the most common site for ectopic salivary tissue
It is cyst in mandible

32
Q

What is ranula?

A

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.

33
Q

What is contraindicated in management of ranula?

A

I & D

34
Q

Most common structure, injured in surgery of salivary glands disease

A

Submandibular duct

35
Q

Most common nerve , injured in surgery of salivary glands disease

A

Lingual nerve

36
Q

What is plunging ranula?

A

Mucus retention cyst ( involving sublingual and submandibular gland)

37
Q

Which management is used in parotid abscess?

A

Incision and drainage using Hiltons method

38
Q

Which sign is seen an x-ray of a patient presents with the recurrent parotitis

A

Snowstorm appearance

39
Q

Which sign is Sinon images of a patient presents with HIV parotitis

A

Swiss cheese appearance

40
Q

What is Kuttner’s tumor

A

Chronic sclerosing Sialadenitis involving submandibular gland

41
Q

What is sialoloithiasis?

A

Stone formation in the salivary glands

42
Q

sialoloithiasis is more common in

A

Submandibular glands > parotid gland

43
Q

in sialoloithiasis most common composition is

A

Calcium phosphate, 80% Stone are radio opaque

44
Q

What is the meal time syndrome

A

Painful postprandial, neck swelling lasting 1 to 2 hours

45
Q

The most common structure, injured in submandibular gland, stone surgery

A

Lingual Nerve

46
Q

Most common benign tumor of salivary gland

A

Pleomorphic adenoma

47
Q

Most common benign tumor of salivary gland in children

A

Hemangioma

48
Q

Most common malignant salivary gland tumor

A

Mucoepidermoid cancer

49
Q

What is the second most common malignant salivary gland tumor

A

Adenoid cystic cancer

50
Q

What is the most common bilateral parotid tumor ?

A

Warthin tumor

51
Q

What is the IOC for pleomorphic adenoma?

A

FNAC

52
Q

Which gene mutation is responsible for pleomorphic adenoma

A

PLAG 1 gene

53
Q

What is BLEL

A

Caused by CMV
Also called Godwin tumor
If it undergoes malignant changes, it is called eskimoma
Management : excision

54
Q

Which gene fusion is responsible for mucoepidermoid cancer

A

CRTCI-MAML2 gene fusion

55
Q

Which incision is made in parotid surgery

A

Lazy Z incision / modified Blair incision

56
Q

 What to do if facial nerve is sacrificed (like in total radical parotidectomy)

A

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

57
Q

Most important pointer for the facial nerve injury

A

It is 1 cm inferior in deep to the tragal pointer/ conley pointer

58
Q

Which nerve is implicated in the frey’s syndrome / gustatory sweating / dupuy syndrome/ auriculotemporal syndrome

A

Auriculotemporal nerve

59
Q

How does parotid fistula of the duct is managed

A

By Newman and Seabrook surgical procedure

60
Q

Most common tumor of submandibular gland

A

Pleomorphic adenoma

61
Q

Most common malignant tumor of submandibular gland

A

Adenoid, cystic, carcinoma

62
Q

Most common sublingual tumor

A

Adenoid cystic cancer

63
Q

Most common theme of minor salivary gland

A

Adenoid cystic carcinoma
MC site ; hard palate

64
Q

Symptoms if intercoastobrachial nerve is injured

A

Anesthesia in axilla post MRM

65
Q

Symptoms if greater auricular nerve is injured

A

Anesthesia while shaving
Seen in post parotidectomy

66
Q

Symptoms of spinal accessory nerve is injured

A

Shoulder dysfunction after neck dissection

67
Q

Symptoms if Iliohypogastric nerve is injured

A

Chronic inguinal pain after open inguinal hernia surgery

68
Q

Symptoms if marginal mandibular now is injured

A

Drooping of angle of mouth

69
Q

Structures which are injured in submandibular gland, surgery

A

Marginal, mandibular nerve
Lingual nerve
Hypoglossal nerve
Anterior facial nerve
Facial artery

70
Q

In submandibular gland, stones stones proximal to the lingual nerve retrieve via

A

Intraoral surgical approach

71
Q

Most common site of branchial cyst is

A

Junction of the upper and middle third of the SCM

Surgery (30 decks)

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