Diagnosis of Head and Neck Swellings - Oral and Maxillofacial Surgery - Lecture Slides, Slides of Oral Biology

Download Diagnosis of Head and Neck Swellings - Oral and Maxillofacial Surgery - Lecture Slides and more Slides Oral Biology in PDF only on Docsity! Differential Diagnosis of Head and Neck Swellings and it’s management Docsity.com Head and Neck Swellings • A number of masses may develop in the head and neck, and these may also be called swellings, growths, tumors, lumps, and bumps. • While some head and neck masses are cancerous, many are not. • However, it is important to investigate if any abnormal bump or swelling persists for more than two weeks. Docsity.com Symptoms Associated with Neck Lumps • Lump in the neck persisting for more than two weeks, especially if it is not associated with a cold, flu, or other infection. • Cancers of the mouth, throat, voice box (larynx), thyroid, and some lymphomas can appear first as a painless, growing neck lump. Docsity.com Symptoms Associated with Head & Neck Lumps • Change in the voice including hoarseness that persists for more than two weeks • Growth in the mouth • Swollen tongue Blood in the saliva or phlegm • Swallowing problems Docsity.com Diagnosing Head and Neck Masses • Examination of some masses / swelling may allow a physician to determine their cause based on location, size, and consistency. • In other cases, however, additional tests may be required. Docsity.com Radiographic Investigation of the Head and Neck Masses • CT SCAN – Computed tomography is less accurate than M.R.I for the soft tissue examination, but is very useful to locate bony tumors and their dimensions and extensions. • C.T with contrast is used to enhance the visibility of abnormal tissue during examination. Docsity.com Radiographic Investigation of the Head and Neck Masses PET (Positron Emission Tomography) and SPECT (Single Photon Emission Tomography) are useful after diagnosis to help determine the grade of a tumor or to distinguish between cancerous and dead or scar tissue. They involve injection with a radioactive tracer. Docsity.com Diagnosing Head and Neck Masses • F.N.A.C – Fine Needle Aspiration Biopsy is • Safe • Rapid • Inexpensive • Presurgical planning • Avoids open biopsy Docsity.com (ii) Benign Swellings of the Head and Neck • Congenital/ Developmental Cysts (i) Thyroglossal cyst (ii) Branchial cyst (iii) Sebaceous cyst (iv) Dermoid cyst Docsity.com Developmental Cyst - ThyroglossalCyst • Most common congenital neck mass • Arrested migration of thyroid • 50% present before age 20 • Midline (75%) or near midline (25%) • Elevates on swallowing/protrusion of tongue • Surgery is the only treatment. Docsity.com Developmental Cyst - Branchial Cyst • Remnants of incompletely obliterated branchial clefts/pouches • Located anterior & deep to sternomastoid muscle. • Painless swelling • Young adults • M = F ratio • Unilateral, 75%of cases on left side. Docsity.com Developmental Cyst Sebaceous cyst • Unless they become infected and painful or large, sebaceous cysts do not require medical attention or treatment, and they usually go away on their own. • If they become infected, the physician may drain the fluid and cells that make up the cyst wall. Or, if the cyst causes irritation or cosmetic problems, it may be removed through a simple excision procedure. Docsity.com Dermoid cyst A dermoid cyst is a congenital defect (present from birth) that occurs during embryonic development when the skin layers do not properly grow together. A dermoid cyst is lined with epithelium, which contains tissues and cells normally present in skin layers, including hair follicles, sebaceous (skin oil), and sweat glands. These glands and tissues secrete their normal substances which collect inside the cyst, causing it to grow and enlarge. Docsity.com Ranula • Ranula presents as a Cystic swelling in the floor of mouth. • It occurs as a mucous extravasation from sublingual salivary gland.• • May extend through the mylohyoid muscles into the neck- “Plunging Ranula” • Surgical treatment is by removal of the Sublingual gland associated with the swelling. Docsity.com (iv) Neoplastic Masses of the Head and Neck • Neoplastic Masses can be classified into two types (i.e) benign and malignant masses. Docsity.com Neoplastic Masses of the Head and Neck Docsity.com Benign Head and Neck Masses • •Any structure of the head and neck may be involved. • Skin, SC Tissue, fat, nerve muscle, blood vessel can be affected. • For example, Lipoma (Fat), Fibroma (Fibrous tissue), Hemangioma( Blood vessel), Neuroma (Nerve). Docsity.com Malignant Masses of the Head and Neck - Malignant masses can occur anywhere in the upper aero-digestive tract. - May also arise from skin and soft and hard tissues of head and neck-SCC, melanoma - It can occur from the salivary glands, thyroid gland, parathyroid gland. Docsity.com Malignant Swellings of the Head and Neck  Head and neck masses are malignant, if they spread to surrounding tissue. In the head and neck, tumors may be either primary or secondary. Docsity.com What are primary tumors?  Primary tumors originate in the head or neck itself, including the thyroid, throat, larynx, salivary gland, brain, or other locations.  Primary tumors of the head and neck typically spread to the lymph nodes in the neck. Docsity.com Treatment of Head and Neck - Squamous Cell Carcinoma • Removal of Primary tumor + cervical nodes • Surgery / Radiation / Chemotherapy • Sometimes palliation • Cervical neck disease reduces survival by 50% Docsity.com Lymphomas  Lymphomas are malignant cell infiltrations of the lymphatic system.  Once a malignancy begins in one part of the lymph system, it often spreads throughout the rest of the system before it is detected. Docsity.com Lymphomas  Lymphomas share similar symptoms such as painless swelling of the lymph nodes, fever and fatigue.  Broadly, they are classified as either non-Hodgkin's and Hodgkin's. Docsity.com