Week 2 - E - Head and Neck Cancer and Facial Plastic Surgery

Question 1

Where is most pathology seen in the mouth?

Answer 1

Side of the tongue or buccal mucosa - must look properly to see it

Question 2

what is MRI best used for?

Answer 2

Soft tissue structures

Question 3

What virus is linked to nasopharyngeal cancer?

Answer 3

EBV

Question 4

How does naspharyngeal cancer usually present?

Answer 4

With hearing loss and a lump in the neck - blocks the eusatchian tube

Question 5

What is the most common presenting location of nasopharyngeal cancer?

Answer 5

Pharyngeal recess - also knwon as fossa of rosenmuller

Question 6

What cancer can joiners get?

Answer 6

Cancer of the sinuses associated with hardwood (adenocarcinoma)

Strong and consistent associations with cancers of the paranasal sinuses and nasal cavity have been observed both in studies of people whose occupations were associated with wood-dust exposure and in studies that directly estimated wood-dust exposure.

Question 7

What are red flags for head and neck cancer?

Answer 7

History of sore throat and hoarseness for greater than 3 weeks Can have difficulty swalloing and also unilateral ear pain

Question 8

What is the most common cancer of the head and neck?

Answer 8

squamous (95%)

Question 9

What is often used to get biopsy from a presenting patient?

Answer 9

Fine needle aspiration with guided ultrasound

Question 10

What are bad risk factors for naso/oro pharyngeal cancers?

Answer 10

Smoking and alcohol

Question 11

What have lumps in the supraclavicular fossa often arisen from and why?

Answer 11

Cancer from the stomach or lungs or testicles etc due to the right thoracic duct inserting into venous system (at angle of left subclavian and internal jugular)

Question 12

How does stridor compare to a wheeze?

Answer 12

Stridor is the opposite of a wheeze Wheeze – high pitch sound on expiration Stridor – harsh, low pitched sound heard on inspiration

Question 13

What are the 4 main methods of basic reconstruction?

Answer 13

* primary closure (immediate or delayed) * Healing by secondary intention * Skin grafts * Skin flaps

Question 14

When would you perform primary closure?

Answer 14

On a tidy laceration, not infected

Question 15

When would you perform delayed closure?

Answer 15

When you have to wait for specialist advice r.e. any internal problems as a result of the trauma

Question 16

Why is a skin flap superior to a skin graft?

Answer 16

* flap already has vascular supply so less likely to fail * skin more likely to match in colour

Question 17

What are the main difficulties of reconstruction of this nose?

Answer 17

* good aesthetics required - nose is an obvious feature * need to preserve function * 3 layers need to be reconstructed

Question 18

The likelihood of head and neck cancers increases with age How does HPV associated cancers differ from this?

Answer 18

They usually present in younger patients