Term
| 6 major categories of the aerodigestive tract |
|
Definition
-lip/oral cavity
-pharynx
-larynx
-nasal cavity
-paranasal sinuses
-major salivary glands
-thyroid |
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|
Term
| MCC of death involving the aerodigestive tract |
|
Definition
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Term
| what is larygneal cancer associated with |
|
Definition
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Term
| is alcohol multiplicative or additive to the development of laryngeal cancer with smoking |
|
Definition
|
|
Term
| what are some other causative factors for laryngeal cancer |
|
Definition
-chewing of betel liquid & tobacco
-HPV
-EBV
-plummer vinson syndrome
-malnutrition
-occupational exposure to carcinogens |
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|
Term
| what is the MC type of head/neck cancer |
|
Definition
|
|
Term
|
Definition
tumor, node, metastasis
-T=extent of the primary tumor
-N=pattern of lymphatic spread
-M=sites of distant spread |
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Term
| which imaging is the best for bony eval |
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Definition
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|
Term
| which imaging is done for the soft tissue evaluation |
|
Definition
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|
Term
| what's the best way to evaluate for head/neck cancers |
|
Definition
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|
Term
|
Definition
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|
Term
| what are the imaging modalities we use to r/o mets (in this order) |
|
Definition
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|
Term
| what's the tx for head/neck cancers |
|
Definition
-surgery
-RT
-chemo
-combo regimens |
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|
Term
| this used to be the common surgical practice for SCC in head and neck cancers |
|
Definition
radical neck dissection:
-remove muscles, jaw, cervical plexus, nodes & cranial nerves |
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|
Term
|
Definition
| modified radical neck dissection that attempts to preserve SCM, CN IX, etc. |
|
|
Term
| what does loss of CN 11 result in |
|
Definition
| denervation of the trapezius-->painful, chronic frozen shoulder |
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|
Term
| where do most lip cancers occur |
|
Definition
|
|
Term
| what's the etiology of lip cancer |
|
Definition
| sunexposure, pipe smoking |
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|
Term
|
Definition
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|
Term
| MC type of lip cancer ON THE UPPER LIP |
|
Definition
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|
Term
| if we have a lip cancer what do we always want to assess for in the PE |
|
Definition
| nerve involvement of the chin |
|
|
Term
| what are the poor prognostic indicators in lip cancer |
|
Definition
-nerve involvement
-fixation to maxilla/mandible
-cancer on upper lip/commisure
-+ nodal dz
-<40 y/o |
|
|
Term
| when do we do a neck dissesction w/ postoperative RT in lip cancer |
|
Definition
|
|
Term
| what is the early stage tx for lip cancer |
|
Definition
|
|
Term
| what is also indicated in advanced stage primary dz, tumors of perineural involvement, or "close" or + margins @ time of resection |
|
Definition
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|
Term
| what are the goals of lip reconstruction |
|
Definition
-re-create oral competence
-cosmesis
-maintain dynamic function while allowing adequate access for oral hygeine |
|
|
Term
| what are the subsites of the oral cavity |
|
Definition
-vermillion border
-buccal mucosa
-upper/lower alveolar ridges
-rectromolar trigone
-floor of mouth
-hard palate
-oral tongue |
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|
Term
| what accounts for 90% of the tumors located in the subsites of the oral cavity |
|
Definition
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|
Term
| what is cancer of the oral cavity associated w/ |
|
Definition
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Term
| 90% of tumors of the oropharynx are |
|
Definition
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|
Term
| what is surgery necessary for tumors of the oropharynx |
|
Definition
-primaray dz involving mandible
-resectable recurrent dz
-easy, superficial tumors that don't justify a full course of radiation |
|
|
Term
| what's the normal tx for tumors of the oropharynx |
|
Definition
|
|
Term
| what are the potential complications of the oropharynx |
|
Definition
-alter swallowing ability
-velopharyngeal insufficiency or nasal regurg of liquids/solids
-possible obstructive sleep apnea |
|
|
Term
| what are the parts of the oropharynx |
|
Definition
-soft palate
-uvula
-tongue
-post. pharyngela wall
-tonsils
-linguil tonsil |
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|
Term
| this location of the pharynx begins @ the soft palate and ends @ the lingual tonsils |
|
Definition
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|
Term
| other than alcohol & smoking what are other factors lead to tumors of hypopharynx |
|
Definition
|
|
Term
| what is plummer vinson syndrome |
|
Definition
| a combo of dysphagia, hypopharyngeal & esophageal webs, weight loss, & iron deficiency anemia |
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|
Term
| how does a pt presents w/ a hypopharynx tumor |
|
Definition
-CHRONIC sore throat
-dysphagia
-referred otalgia
-foreign body sensation in the throat |
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|
Term
| this begins @ the tip of the epiglottis & ends @ the level of the lower border of cricoid cartilage |
|
Definition
|
|
Term
| where does the hypopharynx end and begin |
|
Definition
-tip of epiglottis
-lower border of cricoid cartilage |
|
|
Term
| how do we dx tumors of the hypopharynx |
|
Definition
-fiberoptic endoscopy
-barium swallow
-CT |
|
|
Term
| what determines thyroid cartilage invasion, extension into the neck and LAD in the hypopharynx |
|
Definition
|
|
Term
| what does bx of the hypopharynx usually require |
|
Definition
| direct laryngoscopy under general anesthesia |
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|
Term
| what are the 3 regions of the larynx |
|
Definition
-supraglottis
-glottis
-subglottis |
|
|
Term
| how does a pt present w/ a tumor in the larynx |
|
Definition
-hoarseness
-ear pain or sore throat
-signs of airway compromise occurring later in dz
-dysphagia (weigh loss/malnutrition) |
|
|
Term
| what's the routine for laryngeal lesions & lymph node metastasis |
|
Definition
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|
Term
| how do we tx low grade lesions of the larynx |
|
Definition
| -close f/u w/ repeat laryngoscopy & smoking cessation |
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|
Term
| how do we tx invasive dz of the larynx |
|
Definition
-conservative & aggressive surgery
-RT
-chemoradiation therapy |
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|
Term
| if a pt fails conservative tx for layngeal tumors what is done |
|
Definition
| total laryngectomy w/ permanent tracheostomy |
|
|
Term
| what are some s&s's of nasal cavity & paranasal sinuses tumor |
|
Definition
-epistaxis
-nasal congestion
-HA/facial pain
-orbital involvement (proptosis, orbital pain, diplopia, epiphora, vision loss) |
|
|
Term
| tx for sinonasal malignancies |
|
Definition
-surgical resection
-radiation/chemo for high-grade histologies |
|
|
Term
| what are unresectable lesions |
|
Definition
| brain or bilateral optic n. involvement or carotid artery encasement |
|
|
Term
| what are the benign lesions of the nasal cavity |
|
Definition
-papillopas
-hemangiomas
-benign fibrous histiocytoma
-fibromatosis
-myxoma
-osseous lesions
-angiofibromas |
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|
Term
| MC benign tumor of the nasopharynx |
|
Definition
|
|
Term
| what s&s's suggest malignancy |
|
Definition
-cervical mass
-HA, otalgia
-trismus
-CN involvement |
|
|
Term
| how do we dx tumors of the nasal cavity |
|
Definition
| rigid or flexible nasopharyngoscopes |
|
|
Term
| this is excellent for determining bony destruction, soft tissue involvement and intracranial extension in the nasal cavity |
|
Definition
|
|
Term
| advantage of endoscopic surgeries |
|
Definition
| avoid facial incisions & allow for shorter hospital stays |
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|
Term
| what are the s&s's of tumors of the ear/temporal bone |
|
Definition
-hearing loss, vertigo, eustachian tube dysfunction w/ serious OM
-CN deficits
-pulsatile tinnitus
-drainage
-deep "boring" pain |
|
|
Term
| how do we dx tumor of the ear/temporal bone |
|
Definition
| audiology/vestibular testing (or CT for bone involvement) |
|
|
Term
| how do we tx tumors of the ear/temporal bone |
|
Definition
|
|
Term
| what are the goals of reconstruction for resection of tumors of the ears |
|
Definition
-protect from CSF leaks
-coverage of vital structures & remaining bone
-facial nerve preservation
-cosmesis |
|
|
Term
| what provides acceptable rehab when total auriculectomy has been preformed |
|
Definition
|
|
Term
| acute or chronic inflammation of a salivary gland |
|
Definition
|
|
Term
| what are some causes of sialadenitis |
|
Definition
bacterial (s. aureus)
viral (mumps) |
|
|
Term
| what are the s&s'of tumors of the salivary glands |
|
Definition
| pain, rapid growth, nerve weakness, parethesia, signs of cervical LAD |
|
|
Term
| what may salivary gland tumors by misdx'ed as |
|
Definition
|
|
Term
| how do we dx tumors of the salivary glands |
|
Definition
|
|
Term
| tx for tumors of the salivary glands |
|
Definition
-surgical excision
-RT for high grade
-facial n. preservation |
|
|
Term
| what do cervical masses in children usually represent |
|
Definition
|
|
Term
| this occurs when tissues in the neck & collar bone fail to develop normally leaving open spaces |
|
Definition
|
|
Term
| formation of an OPENING that will close spontaneously |
|
Definition
|
|
Term
| formation of a PERMANENT opening |
|
Definition
|
|
Term
| when is a tracheo(s)tomy commonly done today |
|
Definition
| pt's requiring prolonged mechanical ventilation |
|
|
Term
| what are some other reasons for tracheostomy |
|
Definition
-chronic aspiration
-acute airway obstruction
-periop during radical cancer ablation |
|
|
Term
| what should be done in pre-op before tracheostomy |
|
Definition
-h/o previous tracheotomy/neck surgery
-laryngeal pathology
-bleeding difficulty
-cervical spine injuries |
|
|
Term
| what are some of the peri-op complications of a tracheostomy |
|
Definition
-bleeding
-aspiration
-pneumothorax
-pneumomediastinum
-recurrent laryngeal n. injury
-hypoxia |
|
|
Term
| what does paralysis of the laryngeal muscles occur from |
|
Definition
-CNS lesion
-peripheral n. damage
-malignancies of the thyroid, esopagus, laynx
-compression |
|
|
Term
| what does injury to the recurrent laryngeal nerve |
|
Definition
| vocal fold paresis or paralysis |
|
|
Term
| how may unilateral vocal cord immobility present |
|
Definition
-hoarseness, dysphagia
-aspiration
-airway compromise |
|
|
Term
| how do we make a dx of vocal cord paralysis |
|
Definition
|
|
Term
| how do we tx vocal cord paralysis |
|
Definition
-intracordal injection
-medialization thyroplasty |
|
|
Term
| what does bilateral vocal fold paralysis result in |
|
Definition
| life-threatening airway obstruction & stridoer |
|
|
Term
| where are cosmetic deformities most obvious |
|
Definition
|
|
Term
| what are the general principles of surgical reconstruction |
|
Definition
-reconstructing underlying bony framework
-replacing skin w/ skin of matching quality
-minimizing scar visibility & contracture
-reconstruction in zone of facial units |
|
|
Term
| what are some reconstructive options |
|
Definition
-healing by secondary intention & primary closure @ one end
-extensive reconstruction such as microvascular free flaps |
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