Swelling in Head and Neck

Question 1

Diagnostic - hx taking

Answer 1

1. OPERATES
2. Developmental time course
3. SH - tobacco, alcohol
4. Previous irradiation or surgery

Question 2

Thyroid mass - children vs adults?

Answer 2

Children - male predominance w/ higher incidence malignant

Adult - female predominance mostly benign

Question 3

Signs/ symptoms and diagnosis of lymphoma?

Answer 3

Sign/ symptoms: lateral neck mass - discrete, rubbery and nontender, fever
Diagnosis: biopsy, CT, bone marrow biopsy

Question 4

What would you expect to see in salivary gland tumour?

Answer 4

Enlarging mass anterior/ inferior to ear or angle of mandible

Question 5

Diff benign and malignant salivary gland tumour?

Answer 5

Benign: asymptomatic apart from mass
Malignant: rapid growth, skin fixation, CN palsies

Question 6

What is carotid body tumour?

Presentation, diagnosis and tx

Answer 6

Pulsatile, compressible mass - mobile medial/ lateral

Diagnosis clinical confirmed angiogram or ct

Tx: irradiation, surgical resection, hypotensive anaesthesia

Question 7

Example of congenital and developmental masses?

Answer 7

1. Epidermal and sebaceous cyst
2. Cleft cyst
3. Thryoglossal duct cyst

Question 8

How diagnose epidermal/ sebaceous cyst?

Answer 8

Elevation and movement of underlying skin, skin dimple or pore, confirmed biopsy

Question 9

Presentation and tx clef cysts

Answer 9

Smooth, fluctuant mass underlying SCM - skin erythema and tenderness
Tx: surgical excision, if 1st cleft - total parotidectomy

Question 10

What is thyroglossal duct cyst?

Answer 10

Usually midline and inferior to hyoid bone - elevate on swallowing or protrusion of tongue
Tx: surgical removal