Theme 10 L4: Diseases of the head and neck Flashcards
What is rhinitis and what are the causes?
inflammation of the nasal cavity caused by:
- viruses (RSV, parainfluenza, coronaviruses etc)
- bacteria (haemophilus influenzae)
- inhaled allergen / hypersensitivity reaction
What is sinusitis?
- inflammation of paranasal sinuses
- can be acute or chronic
- blockage of draining orifices can lead to blockage and abscess formation
- in severe cases can cause meningitis, cerebral abscesses
What are nasal polyps?
- soft, fleshy, polupod lesions
- due to chronic allergic irritation or infection
- may be unilateral or bilateral
- can cause nasal obstruction, rhinorrhoea (runny nose) and headaches
What 3 conditions make up Samter’s triad?
nasal polyps, asthma and aspirin intolerance
What is oral lichen planus?
- non infectious inflammatory condition
- immunologically mediated mucocuaneous disorder that often presents as chronic dermatologic disease
- skin itchy, violaceous papules, blisters particularly on palms and soles
- affects oral mucosa mostly
- F>M
What is Wickham striae?
- interlacing white striae
- feature of lichen planus
How do we treat oral lichen planus?
topical steroids - anti - fungal treatment if superimposed fungal infection e.g candidiasis
What is laryngitis?
viral or bacterial
inflammation of the larynx
What is allergic laryngitis?
- inhalation of allergens/ irritants
- if severe can lead to gross oedema and obstruction
What are some causes of vocal cord polyps/ nodules?
due to voice abuse (phonatory trauma), infection (laryngitis), alcohol, smoking
What are the features of vocal cord polyps/ nodules?
- may be single or bilateral
- hoarseness or change in voice
- non-neoplastic stromal reactive process related to inflammation and/or trauma
What are the 3 major salivary glands?
parotid, submandibular and sublingual
What is sialadeitis?
inflammation of the salivary glands
What is another word for viral sialadeitis?
mumps
What is salivary gland mucocele?
General term used to describe minor salivary gland lesions resulting from obstruction secondary to a mucous plug or intraluminal sialolith
What is ranula?
A form of mucus retention cyst or mucus extravasation phenomenon specifically occurring in the floor of the mouth associated with the ducts of the sublingual gland
What is the commonest salivary gland tumour?
pleomorphic salivary adenoma (mixed tumour) –> benign tumour but tend to recur, small proportion can undergo malignant change
What is the most common location of a pleomorphic adenoma?
80% occur in parotid
Other than a pleomorphic salivary adenoma, what are some other tumours that arise in the salivary gland?
- Warthin tumour (benign)
- Mucoepidermoid carcinoma (malignant)
- Adenoid cystic carcinoma (malignant)
What is, by far, the most common malignant neoplasm of the oral cavity?
oral SCC
What are the most common sites for oral cavity carcinoma? (in descending order of frequency)
lower lip tongue floor of mouth gingival palate tonsil upper lip buccal mucosa uvula
What are risk factors of SCC?
- tobacco
- alcohol
- oncogenic viruses: HPV, EBV
- sunlight: lip carcinoma
- plummer vinson syndrome (chronic iron deficiency)
- cirrhosis
- immunocompromised states
Which conditions might be linked with the development of oral carcinoma?
-lichen planus
-submucous fibrosis
other factors include trauma, dental irritation, poor oral hygiene
What are the clinical features of oral SCC?
- Small lesions may be asymptomatic
- Leukoplakia (white patch), erythroplakia (red patch), or speckled leukoplakia (mixed leukoplakin and erythroplakin)
- Mass lesion
- Ulceration
- Pain (local and referred)
- Difficulty swallowing, speaking, chewing and opening the mouth
- Bleeding
- Weight loss
- Enlarged neck nodes (neck mass)/ metastasis
- Advanced tumours can invade into bone, muscle and skin and may form of orocutanoeus fistulas
What are the features of laryngeal cancer?
- associated with cigarette smoking / asbestos workers
- typically unilateral but may be bilateral
- white (leukoplakia), red (erythroplakia) or mixed red and white (speckled leukoplakia)
- M>F
What are 3 features of psoriatic arthritis?
- salmon pink/ scaly plaques
- arthritis (dactylitis)
- nail pitting
What is the defining feature of a SCC?
Keratin layer
Why would a patient with psoriasis be at increased risk of developing cancer?
-due to increased cell turnover, so we have more replication and more opportunities for DNA mutation to occur
How does a sinus show up on a CT?
Black as they’re filled with air
What type of hypersensitivity is bullous pemphigoid?
type II
What complication that can cause death is high for bullous pemphigoid?
sepsis
