Term
| MC cause of death from Head and Neck causes? |
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Definition
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Term
| What increases the odds of developing laryngeal CA? |
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Definition
Tobacco ↑ 15x
Alcohol ↑ 2x |
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Term
| What are some other causes of Laryngeal CA, besides tobacco and alcohol? |
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Definition
HPV
EBV
Plummer Vinson Syndrome |
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Term
| What is the MC type of Laryngeal CA? |
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Definition
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Term
| Pt presents with hoarseness, trismus, hx of dysphagia and odynophagia as well as a 20 pk yr hx, what condition do you suspect? |
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Definition
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Term
| What is the definitive diagnostic procedure for laryngeal CA? |
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Definition
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Term
| What is the term for any white mucosal lesion? |
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Definition
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Term
| What are the 3 diagnostic tests always ordered to r/o mets? |
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Definition
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Term
| What surgery is done to treat head and neck CA that is described as Involving removal of nodal levels I-V, SCM muscle, internal jugular (IJ) vein, CN XI, cervical plexus & submandibular gland? |
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Definition
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Term
| What surgery is done to treat head and neck CA that is described as attempts to preserve SCM, IJ or CN XI in any combo, while removing the CA? |
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Definition
Modified Radical Neck Dissection (MRND)
AKA “Bocca” neck dissection |
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Term
| During a modified radical neck dissection, what can the Loss of CN XI result in? |
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Definition
| denervation of the trapezius→ painful, chronic frozen shoulder |
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Term
| What is the MC type of lip CA on lower lip? |
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Definition
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Term
| What is the MC type of lip CA on upper lip? |
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Definition
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Term
| Which lip do most lip CA occur on? |
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Definition
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Term
| What are the major causes of lip CA? |
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Definition
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Term
| What are the poor prognostic indicators for lip CA? |
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Definition
nerve involvement
fixation to the maxilla or mandible
cancer arising on the upper lip or commissure
positive nodal disease
age < 40 years when diagnosed |
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Term
| What type of CA is MC found in the oral cavity? |
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Definition
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Term
| What are CA of the mouth commonly associated with? |
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Definition
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Term
| What type of CA is MC in the Oropharynx? |
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Definition
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Term
| What are the potential complications for oropharynx CA surgery? |
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Definition
altering capability to swallow
velopharyngeal insufficiency (VPI) or nasal regurgitation of liquids and solids
possible obstructive sleep apnea |
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Term
| What deficiency is common with Plummer-Vinson syndrome? |
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Definition
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Term
| 60y/o Pt c/o of chronic sore throat, foreign body sensation, dysphagia, and referred otalgia. What condition do you suspect? |
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Definition
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Term
| What part of the pharynx is described as tip of the epiglottis and ends at the level of the lower border of the cricoid cartilage? |
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Definition
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Term
| What study can be used to determines thyroid cartilage invasion, extension into the neck, and lymphadenopathy? |
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Definition
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Term
| How is a definitive diagnosis of tumors of the Hypopharynx made? |
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Definition
| Biopsy of the hypopharynx usually requires direct laryngoscopy under general anesthesia |
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Term
| What are the 3 regions of the larynx? |
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Definition
supraglottis (epiglottis)
glottis
subglottis |
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Term
| What imaging is routine for laryngeal lesions and lymph node metastasis? |
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Definition
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Term
| What is the tx for LOW-GRADE laryngeal lesions? |
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Definition
| close follow-up with repeat laryngoscopy, and smoking cessation |
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Term
| What is the tx for INVASIVE laryngeal lesions? |
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Definition
| conservative and aggressive surgery, RT, and chemoradiation therapy |
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Term
| What is the tx for patients who fail conservative tx of laryngeal CA? |
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Definition
| laryngectomy with permanent tracheostomy and the loss of voice |
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Term
| Pt presents with epistaxic episodes, nasal congestion, HA and facial pain for 3 months off and on. Presenting today, b/c she is seeing double. What is a concern? |
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Definition
| Nasal Cavity & Paranasal Sinuses Tumors |
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Term
| What imaging study would you order to r/o or dx tumors of the Nasal Cavity & Paranasal Sinuses? |
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Definition
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Term
| What is the treatment for sinonasal malignancies? |
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Definition
surgical resection
radiation or chemoradiation for high-grade histologies |
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Term
| Which sinonasal malignancies are unresectable? |
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Definition
| those with brain or bilateral optic nerve involvement, or carotid artery encasement |
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Term
| What type of tumor is the MC benign tumor of the nasal cavity? |
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Definition
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Term
| 26 y/o male pt presents with a unilateral nasal obstruction, serous otitis with effusion, c/o of hearing loss and nasal drainage. What condition do you suspect? |
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Definition
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Term
| With an sinonasal mass, what are some signs of malignancy? |
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Definition
CN involvement
Cervical mass
HA
Otalgia
Trismus |
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Term
| How are sinonasal tumors diagnosed? |
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Definition
| rigid or flexible nasopharyngoscopes |
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Term
| Which imaging study is excellent for determining bony destruction, soft tissue involvement and intracranial extension with sinonasal tumors? |
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Definition
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Term
| What type of surgery may be done to remove sinonasal tumors, that avoid facial incisions and allow shorter hospital stays? |
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Definition
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Term
| Pt presents of deep, boring ear pain, with pulsatile tinnitus, hearing loss and vertigo. On PE you note CN deficits and drainage. What condition do you suspect? |
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Definition
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Term
| What is the diagnosis for ear or temporal bone CA? |
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Definition
| Audiology and vestibular testing as well as CT (eval bony involvement) |
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Term
| What is the treatment for ear or temporal bone tumor? |
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Definition
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Term
| Term meaning an acute or chronic inflammation of a salivary gland |
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Definition
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Term
| Term meaning obstructive calcifications in the duct? |
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Definition
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Term
| In what infectious disease are swollen parotid glands a common symptom? |
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Definition
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Term
| What can salivary tumors be misdiagnosed as? |
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Definition
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Term
| Pt presents with rapid growth of the salivary glands, pain, nerve weakness and paresthesias. What condition are you considering? |
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Definition
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Term
| What is the diagnosis of a salivary gland tumor? |
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Definition
| FNA cytology of the salivary glands with excision of the gland |
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Term
| What is the treatment for salivary gland tumors? |
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Definition
surgical excision
RT for high-grade malignancies |
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Term
| What symptom is suggestive of malignancy associated with salivary gland tumors? |
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Definition
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Term
| What do cervical masses in children often represent? |
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Definition
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Term
| What do cervical masses in adults often represent? |
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Definition
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Term
| Term meaning formation of a temporary opening that will close spontaneously (5-7 days)? |
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Definition
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Term
| Term meaning formation of a permanent opening (remains open after removal of the tube)? |
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Definition
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Term
| When is a tracheostomy MC used? |
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Definition
| used today in patients requiring prolonged mechanical ventilation (after 3 days of intubation - 2 to 3 weeks) |
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Term
| What are the peri-op complications of a tracheostomy? |
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Definition
Recurrent laryngeal nerve injury
bleeding
aspiration
pneumothorax
pneumomediastinum |
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Term
| What does injury to the recurrent laryngeal nerve result in? |
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Definition
| vocal fold paresis or paralysis - usually unilateral |
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Term
| pt presents with hoarseness, dysphagia, aspiration and airway compromise, what condition do you suspect? |
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Definition
| Unilateral vocal cord immobility |
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Term
| How is vocal cord paralysis dx? |
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Definition
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Term
| What is the treatment for vocal cord paralysis? |
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Definition
intracordal injection
medialization thyroplasty(removing thyroid cartilage and replace by silicone to push the cord medially closed) |
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Term
| What can the uncommon scenario of bilateral vocal fold paralysis result in? |
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Definition
| life-threatening airway obstruction and stridor |
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Term
| What is the treatment for bilateral vocal cord paralysis? |
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Definition
| immediate reintubation or tracheotomy |
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Term
| Where are cosmetic deformities from surgical resection most obvious? |
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Definition
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Term
| What are the general principles behind surgical reconstruction? |
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Definition
- reconstruct underlying bone
- replace skin
- minimize scar visibility |
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