Cancer
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| What type of cancer is most head and neck cancer? | squamous cell cancer (90%)
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| Head and neck cancers that start in the glandular cells are called what? | adenocarcinomas
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| Asymptomatic masses in the head and neck of ppl over 40 are what until proven otherwise? | cancer
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| what is the most common skin cancer? | basal cell carcinoma-least likely to metastasize.
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| Squamous cell carcinoma usually metastasizes to where? | the lymph-->lungs-->liver and bones
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| What is a benign tumor that arises from the vestibular division of the 8th CN from schwann cells? | Acoustic neuroma (vestibular schwannoma)
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| What are the symptoms of acoustic neuromas? | -gradual unilateral sensorineural hearing loss with tinnitus.
-10% have sudden hearing loss.
-vertigo
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| How do you diagnose acoustic neuromas? | CT or MRI with contrast
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| How do you treat acoustic neuromas? | surgery
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| describe the location of malignant tumors of the ear? | 85%-of the auricle
10%-in the external canal
5%-middle ear and mastoid
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| Symptoms of malignant tumors in the ear? | -deep boring bone pain, disproportionate to what is seen on exam.
-may have conductive hearing loss
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| What can cause malignant tumors of the nose and sinuses? | exposure to nickle, dust, Thorotrast(contrast medium). Usually not from tobacco.
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| what is the common age/gender of nose/sinus cancer? | over 50yo, male/female 2:1 ratio.
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| What is the main type of nose/sinus cancer? | squamous cell
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| What is a common finding for Nasopharyneal cancer? | -asymptomatic enlarged cervical node or a unilateral serous otitis media in an adult.
-exposure to Epstein-Barr virus
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| Where is adenocarcinoma usually found? | ethmoid sinus in patients under 40yo. It is usually slow growing.
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| Describe esthesioneuroblastoma. | rare, found in young adults in mid 20's. Usually found in the roof of the mouth.
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| What are the symptoms of esthesioneuroblastoma? | unilateral nasal obstruction, loss of smell, epistaxis
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| Describe juvenile nasopharyngeal angiofibroma. | benign and found in males 7-19. It invade sthe base of the skull and can cause massive bleeding and death. Obstruction and epistaxis are most common symptoms.
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| What are major contributors to laryngeal cancers? | smoking and alcohol
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| Laryngeal cancer is almost exclusively what type? | squamous cell
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| To determine laryngeal cancer you must do 5/6 steps. What are they? | 1-palpation of cervical soft tissue
2-indirect laryngoscopy with mirror
3-direct larygoscopy with biopsy
4-xray
5-CT or MRI
6-contrast studies(barium/upper GI)
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| Describe glottic cancer. | occurs at the cords. Causes hoarseness, scratchy pain, dysphagia, cough, and stridor. PE shows irregular white/red growths-cauliflower look.
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| Describe subglottic cancer. | Symptoms are same as glottic, may see a superficial ulceration
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| Describe cancer in the marginal zone. | -involves the aryepiglottic folds
-proliferative, fungating with central ulcerations and heaped up margins.
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| Oral cancer accounts for 50% of cancers in what populations? | Asian and Indian populations
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| 40% of all head and neck cancers occur where? | Oral cavity
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| What are risk factors for oral cancer? | -tobacco use
-heavy alcohol use
-chewing betel nut
-nutritional factors
-genetic factors
-sun exposure
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| Describe lip cancer. | found in 50-70yo. 95% males. fair skinned complexion, with sun exposure and pipe smoking as RFs.
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| Describe Mouth/buccal cancer. | accounts for 34% of oral cancers. will see red ulcerated patch that is non-healing and painless with rolled borders.
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| Describe tongue cancer. | presents late stage on the anterior 2/3 of tongue. Can have serious odynophagia or otalgia.
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| What is leukopakia? | white, plaque-like lesion. tends to be pre-malignant or malignant.
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| What is erythroplakia? | red plaque-like lesion. more commonly malignant than leukoplakia.
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