Documenti di Didattica
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Justin Dumouchel
9/14/05
Anatomy
Anterior Triangle middle of the neck, the
sternocleidomastoid muscle and lower
border of the mandible
-submental triangle
-submandibular triangle
Posterior Triangle- sternocleidomastoid, the
anterior border of the trapezius, and the
middle third of the clavicle
Triangle Anatomy
Progressively enlarging
nodes
A single asymmetric
node
A persistent nodal mass
without antecedent
active signs of infection
Actively infectious
condition that do not
respond to conventional
antibiotics
Imaging techniques
Radionucleotide scanning
Sialography
Ultrasonography
Arteriography
CT and MRI imaging
PET not advocated at this time
T2 2 4 cm
T4 invasion of
N0 no positive nodes
N1 single node < 3 cm
N2a single node 3 6 cm
N2b multiple homolateral nodes
< 6 cm
N2c multiple bilateral nodes < 6
cm
N3 -- Nodes > 6 cm
M (distant metastasis)
Stages
I - T1M0N0
II T2N0M0
III T3N0M0
-- T1-3,N1M0
IV - T1-3,N2-3M0
T1-3N0-3M1
1) wound necrosis
2) regional neck recurrence
3) distant metastasis
4) all of the above
Thyroid Carcinoma
15% of papillary carcinoma present with
lymph node metastasis (80% of thyroid
carcinoma)
Investigate mass initially with FNA (then +/thyroid scan and +/- ultrasound)
Salivary Neoplasms
Benign: usually asymptomatic (common)
Malignant sx: pain, rapid growth, CN VII
sxs, or skin fixation suggest malignancy
Parotid most common and often benign
Smaller glands are more likely malignant
Definitive surgery should be performed at
biopsy to prevent seeding of benign
tumors.
Salivary Neoplasms
Benign
Pleomorphic adenoma 65% of parotid tumors
Adenolymphoma (Warthins tumor) 6 10% of
parotid tumors (frequently bilateral)
Malignant
Mucoepidermoid Carcinoma most common
salivary gland malignancy
Thank you