Syndromes of the head and neck Flashcards
POLYOSTOTIC FIBROUS DYSPLASIA - MULTIPLE BONES AFFECTED
CAFE AU LAIT SPOTS - PATCHY SKIN PIGMENTATION
ENDOCRINE ABNORMALITIES (PRECOCIOUS PUBERTY IN GIRLS)
FACIAL ASYMMETRY 25% OF CASES
Albright syndrome (McCune - Albright syndrome )
RARE DEVELOPMENTAL DISORDER
CRANIOSYNTOSIS - PREMATURE FUSION OF CRANIAL SUTURES
SYNDACTYLY - FUSION OF FINGERS AND TOES.
SEVERE MIDFACE RETRUSION LEADS TO EXOPHTHALMOS
EARLY SURGICAL INTERVENTION TO PREVENT BLINDNESS FROM SUBLUXATION OF THE GLOBE OF EYE
APERT SYNDROME
EXOMPHALOS MACROGLOSSIA GIGANTISM ADRENAL AND RENAL ABNORMALITIES HYPOGLYCEMIA TONGUE REDUCTION MAYBE REQUIRED
BECKWITH - WIEDEMANN SYNDROME
ORAL ULCERS WITH TWO OF SKIN LESIONS
UVEITIS
GENITAL ULCERS
BLISTERING OF SKIN WHEN CANNULATED
MULTISYSTEM DISEASE OF IMMUNOLOGICAL ORIGIN
TREATMENT : AZATHIOPRINE, CYCLOSPORIN, THALIDOMIDE
BEHCET’S DISEASE
MAXILLONASAL DYSPLASIA
MIDFACIAL RETRUSION
ABSENT OR HYPOPLASTIC FRONTAL SINUSES
NO ASSOCIATED INTELLECTUAL DEFECT
BINDER SYNDROME
MASSIVE CERVICAL SWELLING RESEMBLING LYMPHOMA BUT NO IDENTIFIABLE MALIGNANT CELLS
SOME VARIANTS ARE BENIGN, SOME CONSIDERED PREMALIGANT
BENIGN GIANT LYMPHNODE HYPERPLASIA - ANOTHER NAME
CASTLEMAN SYNDROME
DEFECTIVE NEUTROPHIL FUNCTION ABNORMAL SKIN PIGMENTATION INCREASED SUCEPTIBILITY TO INFECTIONS SEVERE GINGIVITIS, PERIODONTITIS AND APTHAE IN YOUNG CHILDREN) GENETIC
CHEDIAK HIGASHI SYNDROME
DYSPLASIA OR APLASIA OF THE CLAVICLE
DELAYED OSSIFICATION OF CRANIAL FONTANELLES
LARGE SHORT SKULL
SHORTNESS OF STRATURE, FRONTAL AND PARIETAL BOSSING
FAILURE TO PNEUMATISE SINUSES
HIGH ARCHED PALATE OR CLEFTING
FAILURE OF TOOTH ERUPTION & MULTIPLE SUPERNUMERARIES, DILACERATED ROOTS AND GEMINATION OF CROWNS
HYPOPLASIA OF CEMENTUM
AFFECTS MEMBRANOUS BONE
CLEIDOCRANIAL DYSOSTOSIS (CLEIDOCRANIAL DYSPLASIA)
CHROMOSOMAL ABNORMALITY - CAUSED BY DEPLETION OF SHORT ARM OF CHROMOSOME 5 RESULTING IN -
MICROCEPHALY
HYPERTELORISM
ROUND FACE WITH BROAD NASAL BRIDGE
MALFORMED EARS
ASSOCIATED LARYNGEAL HYPOPLASIA - SHRILL CRY
INTELLECTUAL DISABILITY
“CRI DU CHAT” SYNDROME
COMMONEST CRAINIOSYNTOSIS
AUTOSOMAL DOMINANT - PREMATURE FUSION OF CRANIAL SUTURES
MIDFACE HYPOPLASIA CAUSES SHALLOW ORBITS AND PROPTOSIS OF THE GLOBE OF THE EYE
RADIOGRAPHICALLY - BEATEN COPPER SKULL
ENLARGING BRAIN TRAPPED IN FUSED SUTURES - CEREBRAL DAMAGE - SURGERY INDICATED TO PREVENT THIS
CROUZON SYNDROME
COMMONEST OF ALL MALFORMATION SYNDROMES, AFFECTING 1:1600
RISK WITH MATERNAL AGE
FACE - BRACHYCEPHALY WITH MID FACE RETRUSION
SMALL NOSE
FLATTENED NASAL BRIDGE
UPWARD FACING PALPEBRAL FISSURES - MONGOLOID SLANT
MACROGLOSSIA
DELAYED ERUPTION OF TEETH
MAJOR RELAVANT ASSOCIATION - HEART DEFECTS, ATLANTO AXIAL SUBLUXATION, ANAEMIA, INCREASED RISK OF LEUKEMIA
DOWN SYNDROME - TRISOMY 21
Dysphasia
Pain on chewing and turning due to elongated styloid process
Eagle syndrome
Inherited Hyper-flexibility of joints Increased bleeding and bruising Hyperextensible skin. Molecular abmormality of collagen in this disorder Bleeding common in type IV *Early onset periodontal disease in type VIII* *Pulp stones maybe seen in all types *
Ehler-Danlo’s syndrome
Gustatory sweating
Flushing of skin
Following Trauma to the skin overlying a salivary gland or superficial parotidectomy
Due to post traumatic cross over of sympathetic and parasympathetic innervation of grand to skin
Iodine starch test
Frey syndrome
Multiple osteomas in jaws and facial bones Multiple polyps of large intestines Epidermoid cysts Fibromas of skin Autosomal dominance inheritance X rays reveal facial osteomas Polyps have a tendency to have malignant change Worthwhile syndrome
Gardener syndrome
Variant of hemifacial microsomia Microtia - small ears Macrostomia Agenesis of mandibular Ramus and condyle Vertebral abnormalities - hemivertibrae Epibulbar dermoids Cardiac, renal and skeletal abnormalities can occur May have intelectual disability
Goldenhar syndrome
Multiple basal cells ( epitheliomas)
Multiple jaw cysts - odontogenic keratocysts
Vertebral and rib abnormalities
Calcification of falx cerebri
Frontal bossing and mandibular prognathism
Hypertelorism, hydrocephalus and eye and endocrine abnormalities
Gorlin- Goltz syndrome - multiple basal cell naevus syndrome
Autoantibodies to TSH cause hyperthyroidism with ophthalmopathy
Women - 30-50 years
Exopthalmos
Graves’ disease
Sarcoidosis with associated lacrimal and salivary - parotid swelling, uveitis, fever
Associated neuropathies - facial palsy
Heerfordt syndrome (uveoparotid fever)
Prevalence - 1:5000 births
Bilateral 20% of cases
Congenital defect characterised by lack of hard and soft tissue on affected side
Usually in the ramus and external ear - first and second branch oak arches)
Wide spectrum of ear and cranial deformities
Hemifacial microsomia
Three broad groups of histological tissue infiltration of tumour like aggregates of macrophages (histiocytes) and eosinophils
- Solitary eosinophilic granuloma - males, mandible.
- Hand-schuller- Christian disease - multifocal eosinophilic granuloma, skull lesions, DI - younger age group.
- letterer-siwe disease - rapidly progressive, disseminated histocytosis, associated pancytopenia, multi system disease, fatal
Histiocytosis - X
Constricted pupil (miosis) Drooping eyelid (ptosis) Unilateral loss of sweating (anhidrosis) on face Sunken eye (enophthalmos) Cause - interruption of sympthatetic nerve fibres at cervical ganglion 2* to bronchogenic carcinoma, invading the neck ganglion or neck trauma. High on worthwhile
Horner syndrome