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CHAPTER 16 Head

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Title: CHAPTER 16 Head & Neck (ENT) PATHOLOGY OTOLARYNGOLOGY Author: Popeye Last modified by: abc Created Date: 10/24/2005 3:07:03 PM Document presentation format – PowerPoint PPT presentation

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Title: CHAPTER 16 Head


1
ENT
Nasopharynx
Oropharynx
Laryngopharynx
Esophagus
2
Head Neck (ENT) PATHOLOGYOTOLARYNGOLOGY
3
Objective Understand the common disorders of
the upper airway and upper digestive tract (i.e.,
head and neck) in the usual context
of DEGENERATIVE, INFLAMMATORY, and NEOPLASTIC de
viations of normal anatomy and histology
4
.ETIOLOGY .PATHOGENESIS
.MORPHOLOGY .CLINICAL
MANIFESTATIONS
5
EVERYTHING that touches AIR (columnar) or FOOD
(squamous) in the HEAD/NECK region
ORAL CAVITY UPPER RESPIRATORY
TRACT EARS NOSE SALIVARY GLANDS
6
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7
ORAL CAVITY
  • TEETH/GINGIVA/ALVEOLAR BONE
  • INFLAMMATORY/REACTIVE LESIONS
  • INFECTIONS HSV, VIRAL, FUNGI
  • LEUKOPLAKIA/HAIRY LEUKOPLAKIA
  • SQUAMOUS TUMORS BEN/MALIG
  • ODONTOGENIC CYSTS/TUMORS

8
UPPER AIRWAYS
  • NOSE Inflammation, Tumors
  • NASOPHARYNX Inflammation, Tumors
  • PARANASAL SINUSES Inflammation, Tumors
  • LARYNX Inflammation, Tumors

9
EARS
  • DEGENERATION OTOSCLEROSIS
  • INFLAMMATION
  • NEOPLASMS

10
NECK
  • BRANCHIAL (cleft) CYST
  • THYROGLOSSAL (duct/tract) CYST
  • PARAGANGLIOMA (Carotid Body Tumor)

11
SALIVARY GLANDS
  • DEGENERATION Xerostomia
  • INFLAMMATION
  • NEOPLASMS
  • BENIGN Pleomorphic Adenoma (aka, Mixed Tumor),
    Warthin Tumor
  • MALIGNANT (Mucoepidermoid, Adenoid Cystic,
    Adenocarcinomas)

12
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13
Tooth Decay (Cavities, Caries)
  • Processed carbohydrates, i.e., sugars
  • Bacterial (Strep. mutans, lactobacilli) acidic
    erosion of enamel
  • Role of pH, spacing, brushing, Fl
  • Tartar?plaque?calculus bacteria, proteins, cells

14
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16
Periodontal Disease
  • Bacteria
  • Actinobacillus
  • Porphyromonas
  • Prevotella
  • Gingiva, periodontal ligaments, bone, cementum

17
Irritation Fibroma
18
PYOGENIC GRANULOMA
19
Canker sore Aphthous ulcer
20
Glossitis
21
herpes
22
Herpes, dried vesicle with inflammation
23
Herpes, dried vesicle with ulceration and
secondary inflammation. Acute or chronic?
24
TZANCK SMEAR
25
Monilia, thrush-mouth
26
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28
LEUKOPLAKIA.
29
Hairy leukoplakia
30
Hairy leukoplakia
31
NORMAL? DYSPLASIA? CARCINOMA-IN-SITU?INFILTRATING
MALIGNANCY
32
INFILTRATIVE SQUAMOUS CELL CARCINOMA
33
squamous cell cancer,
34
WELL MODERATE POOR
35
ODONTOGENICCYSTS/TUMORS
  • INFLAMMATORY CYSTS (e.g., Radicularperiapical
    most common)
  • DEVELOPMENTAL CYSTS (DENTIGEROUS most common)
  • MALIGNANT TUMORS of ODONTOGENIC ORIGIN
    (AMELOBLASTOMAS) (rare)

36
DENTIGEROUS CYST
37
Rhinitis/Sinusitis
  • Very often allergic, a swab showing many
    eosinophils may prove this
  • Very often associated with URIs in general,
    usually viral
  • Just about every organism imaginable has been
    implicated at one time or another, bacteria,
    virus, fungus, etc.

38
NOSE/SINUS/NASOPHARYNXTUMORS
  • Polyps---really NOT a tumor
  • Angiofibroma
  • Papilloma
  • Plasmacytoma
  • Neuroblastoma
  • Nasopharyngeal Carcinoma

39
INFLAMMATORY POLYPS OF NASAL CAVITY
40
Multiple appearances of nasal polyps
41
NECROTIZING Upper Airway Lesions
  • WEGENER Granulomatosis
  • Lethal Midline Granuloma

42
PAPILLOMA
INVERTED PAPILLOMA
43
ANGIOFIBROMA
44
PLASMACYTOMA
45
NEUROBLASTOMA(OLFACTORY)ESTHESIONEUROBLASTOMA
ROSETTE
46
NASOPHARYNGEALCARCINOMA
47
normal vocal cords.
48
LARYNGITIS
49
POLYPS PAPILLOMASCARCINOMAS
50
Polyp, or singers nodule
51
Papilloma, but there may be some cancer
microscopically.
52
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54
Otitis externa
55
normal tympanic membrane.
56
The Tympanic Cavity
57
Acute middle ear infection
58
Chronic serous otitis media
59
Cerumen impaction
60
CERUMEN CAST
61
OTOSCLEROSIS
62
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63
ZELLBALLEN
CAROTID BODY TUMOR balls of cells zellballen
64
NORMAL ACUTE SIALADENITIS CHRONIC SIALADENITIS
65
Squamous metaplasia of an interlobular duct
66
Mucocele of an accessory salivary gland duct,
67
MUCOCELE
68
P A R O T I D
69
Viral parotitis, i.e., mumps
70
Most Common SALIVARY Gland Tumors
  • BENIGN
  • PLEOmorphic adenoma, i.e., MIXED tumor
  • Warthin Tumor (PAPILLARY CYSTADENOMA
    LYMPHOMATOSUM)
  • MALIGNANT
  • All are adenocarcinomas. Why?
  • Mucoepidermoid carcinoma
  • Adenoid cystic carcinoma

71
PLEOMORPHIC ADENOMA i.e., MIXED TUMOR
72
PAPILLARY CYSTADENOMA LYMPHOMATOSUM Better known
as WARTHIN TUMOR
73
MUCOEPIDERMOID CARCINOMA
74
ADENOID CYSTIC CARCINOMA
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