head and neck tumors

Sialolithiasis

salivary stones that can lead to duct obstruction

submandibular gland

gland most associated with sialolithiasis

Pain + swelling with meals 🍽️

Intermittent obstruction

Palpable stone (sometimes)

classic presentation of sialolithiasis

sialadenitis

Inflammation of the salivary gland (usually unilateral)

S. aureus

most common organism of sialadentis

Painful swollen gland

Fever

Purulent discharge from duct (key finding)

presentation of sialendentis

Dehydration

Elderly

Postoperative

Anticholinergic meds

risk factors for sialendentis

Sjogren's syndrome

autoimmune destruction of minor salivary glands and lacrimal glands

lymphoma

cancer associated with sjogren syndrome

Parotid tumors = usually benign

Submandibular/sublingual = more likely malignant

which types of salivary tumors are more likely to be benign vs malignant

pleomorphic adenoma

most common benign salivary tumor

-slow growing, painless mass

Mucoepidermoid carcinoma

most common malignant salivary tumor

malignancy

a salivary tumor with facial nerve involvement indicates

Imaging (CT/MRI)

Fine needle aspiration (FNA)

work up indicated for salivary tumor

parotid tumor

facial nerve weakness is related to this tumor

squamous cell carcinoma

most common type of oral cancer

lateral tongue

most common location of oral cancer

Tobacco 🚬

Alcohol 🍺

HPV (oropharyngeal more than oral cavity)

main risk factors for oral cancer

biopsy

gold standard tool to evaluate oral cancers

submandibular gland

most common site of salivary stones

HPV-16

HPV type most associated with oropharyngeal cancers

Younger patients

Minimal smoking history

Often present with neck mass (lymph node)

-better prognosis than smoking related

typical pt profile of HPV oropharyngeal cancer

Tobacco (strongest)

Alcohol (synergistic 🚨)

Chronic irritation

risk factors for smoking related oral cancer

HPV: oropharynx

smoking: oral cavity

location of HPV vs smoking related oral cancers

-facial nerve in parotid surgery

-lingual nerve injury

-hypoglossal nerve injury

major surgical risks of salivary and oral cancer surgery

Frey syndrome

a rare syndrome characterized by undesirable sweating and flushing occurring on the cheek, temporal region, and behind the ears after eating certain foods

-post-parotid surgery

parathyroid adenoma

most common cause of primary hyperparathyroidism

Bone pain

Kidney stones

Abdominal pain

Depression/confusion

what are the classic symptoms of primary hyperparathyroidism

↑ PTH

↑ calcium

↓ phosphate

lab findings associated with primary hyperparathyroidism

sestamibi scan

most comon localization tool to localize hyperparathyroidism