Infections - Columbia University...Infections Nasal Cavity Paranasal Sinuses Viral Bacterial Polyp...
Transcript of Infections - Columbia University...Infections Nasal Cavity Paranasal Sinuses Viral Bacterial Polyp...
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Infections
Nasal CavityParanasal Sinuses
ViralBacterial
Polyp
Any growth protruding from mucous membrane
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Polypoid LesionsNasal Cavity, Paranasal Sinuses
1. Inflammatory polyp2. Benign tumors3. Malignant tumors
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Inflammatory PolypsNasal Cavity, Sinuses
A. CommonB. Allergy, infectionC. One, multipleD. ObstructionE. BleedingF. Up to 1.5cm
PapillomatosisInverted PapillomasSqamous Papillomas
1. One, multiple polyps2. Nasal cavity, sinuses3. Nasal obstruction4. Bleeding5. 25 to 50x less common
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Papillomatosis
A. Human Papilloma Virus
B. Recurrences: 50 – 70%Multiple RecurrencesInvasive Carcinoma: 5%
1. Uncommon2. Papillomatosis3. Chronic infections4. Wood workers5. Nickel smelting6. Thorotrast
CarcinomaNasal Cavity, Sinuses
1. Polyp, mass2. Obstruction3. Epistaxis4. Pain
CarcinomaNasal Cavity, Sinuses
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A. Destructive lesions nasal cavity, sinuses
B. Perforation, nasal septum
C. Collapse, nasal bridge
Lethal Midline GranulomaMidline Granulomatous Disease
Malignant lymphomasWegener’s GranulomatosisCarcinomaSyphilisTBC, Leprosy, FungusCocaine Sniffing
Lethal Midline Granuloma
1. Hyperplastic lymphoid tissue: Nasopharynx
2. Difficulty breathing3. Middle ear infections
Adenoids
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1. Epistaxis2. Middle ear infections3. Met.: Cervical L.N.4. Cranial nerve paralysis5. Nasopharyngoscope6. Biopsy7. Radiation therapy
Carcinoma, Nasopharyx
1. Chinesea) In chinab) Exiles
2. Middle East3. HLA subgroups4. Wood smoke esp. childhood5. High titers: EB Virus
? Transforming Agent
Carcinoma of Nasopharyx
1. Common2. Children3. Tympanic membrane ruptures4. Chronic otitis media5. Mastoiditis6. Myringotomy
Middle Ear Infections(Acute, Chronic Otitis Media)
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1. Chronic otitis media2. Cuboidal epithelium replaced
by squamous epithelium3. ? Metaplasia
? Ingrowth4. Keratin: Mass5. Destruction of ossicles
Cholesteatoma
1. Nasopharynx2. Tonsils3. Lingual tonsils4. Uvula, pharynx5. Hypopharyx
Waldeyer’s RingLymphoid Tissue
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Squamous cell carcinoma
Oral cavity, oropharynxPharynx, hypopharynxEsophagus
Smoking, drinking
Tumors: pharynx
1. Dysphagia2. Ulcers, masses3. Unilateral tonsillar swelling4. Squamous cell carcinoma
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Polyps of Vocal Cord
1. Common2. Hoarseness3. ? Voice abuse4. Polypectomy
Papillomas: Larynx
Young peopleHoarsenessHuman Papilloma Virus
Leukoplakia
1. HyperplasiaHyperkeratosis
2. Dysplasia3. In situ carcinoma4. Invasive carcinoma
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Squamous Cell CarcinomaLarynx
1. 10,000 new cases / year2. Heavy smoking3. Vocal apparatus:
hoarseness4. Supraglottic area: large;
dysphagia
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“Minor” Salivary GlandsSerous and Mucous GlandsNasal CavityParanasal SinusesNasopharynxOral CavityPharynxEsophagusLarynxTracheaBronchi
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Salivary Gland Tumors
Parotid: 75%Submandibular: 10%Sublingual: rareMinor salivary glands 15%
Benign and Malignant Tumors by Site
50%50%Lacrimal45%55%“Minor” Glands
100%--Sublingual45%55%Submandibular20%80%Parotid
MalignantBenignSite
Benign Mixed Tumors
Most commonSlowly growing, painlessMiddle agedFemales: 60%