ENT Class 8 Qs

1. Types and classification of laryngeal tumours

• Benign tumours: Papilloma, polyp, nodule, cyst, hemangioma, chondroma.

• Malignant tumours: Mostly squamous cell carcinoma (SCC), rare sarcoma or adenocarcinoma.

• Classification by location:

  • Glottic (true vocal cords).

  • Supraglottic (epiglottis, false cords, aryepiglottic folds).

  • Subglottic (below vocal cords).

2. Types and classification of tumours of the nose and paranasal sinuses

• Benign: Inverted Papilloma, osteoma, hemangioma, fibroma, angiofibroma.

• Malignant: Squamous cell carcinoma (most common), adenocarcinoma, adenoid cystic carcinoma, lymphoma, melanoma, sarcoma.

• Classification by site:

  • Nasal cavity.

  • Maxillary sinus.

  • Ethmoidal sinus.

  • Sphenoidal and frontal sinuses (rare).

3. Types and classification of pharyngeal tumours:

• Benign: Papilloma, fibroma, hemangioma, lipoma.

• Malignant: Squamous cell carcinoma (most common), lymphoma, adenocarcinoma, sarcoma.

• Classification by region:

  • Nasopharynx (common: carcinoma, lymphoma).

  • Oropharynx (palatine tonsil, tongue base tumours).

  • Hypopharynx (pyriform sinus, postcricoid area).

4. Aetiological factors for laryngeal tumour

• Smoking (major risk factor).

• Alcohol abuse (synergistic with smoking).

• Occupational exposures (wood dust, asbestos, paint fumes).

• Chronic laryngitis, vocal cord trauma.

• HPV infection (esp. papillomas).

5. Early symptoms of laryngeal tumour:

• Persistent hoarseness/dysphonia: Most common, especially in glottic cancers.

• Foreign body sensation or mild throat discomfort.

• Dry cough or slight hemoptysis.

6. Early symptoms of nasal and paranasal sinus tumour

• Unilateral nasal obstruction or congestion.

• Recurrent epistaxis.

• Persistent purulent or blood-stained nasal discharge.

7. Inverted papilloma & treatment

• Definition: Benign but locally aggressive tumour of the nasal cavity/paranasal sinuses with high recurrence and potential malignant transformation (into SCC).

• Treatment:

  • Surgical excision is mandatory (endoscopic or open).

  • Long-term follow-up due to recurrence risk.

8. Please, name the stages of the laryngeal tumour, main division criteria!

• Stage I: Tumour limited to one region (glottis/supraglottis/subglottis), vocal cord mobility preserved, no nodes.

• Stage II: Involvement of more than one region or impaired vocal cord mobility, no nodes.

• Stage III: Local spread with vocal cord fixation or spread outside larynx, or single ipsilateral lymph node <3 cm.

• Stage IV: Extensive local invasion and/or multiple/bilateral lymph nodes or distant metastasis.

main criteria = TNM system

• T (Tumor): how big the tumor is and how far it spreads locally (T1 = small, T4 = very advanced).

• N (Nodes): whether regional lymph nodes are affected (N0 = none, N1–N3 = more/larger nodes).

• M (Metastasis): whether the cancer has spread to distant organs (M0 = none, M1 = present).

• The TNM combination gives the cancer stage (early vs advanced).

9. Please, name the stages of the paranasal sinus tumour, main division criteria!

• Stage I: Limited to sinus mucosa, no bone erosion.

• Stage II: Bony invasion but confined to sinus.

• Stage III: Extension to adjacent structures (orbit, oral cavity, nasal cavity, ethmoid).

• Stage IV: Invasion of cranial base, pterygoid plates, nasopharynx, or distant metastasis.

main criteria = TNM system

• T (Tumor): how big the tumor is and how far it spreads locally (T1 = small, T4 = very advanced).

• N (Nodes): whether regional lymph nodes are affected (N0 = none, N1–N3 = more/larger nodes).

• M (Metastasis): whether the cancer has spread to distant organs (M0 = none, M1 = present).

• The TNM combination gives the cancer stage (early vs advanced).

10. Basic principles of surgical treatment of laryngeal tumour

• Complete Resection: Remove the entire tumor with clear surgical margins.

• Organ Preservation: Prioritize partial removal (partial laryngectomy) to maintain function for early-stage tumors.

• Functional Restoration: Post-surgery, rehabilitation is key for speech and swallowing.

• Neck Dissection: Remove lymph nodes in the neck if there is a risk of cancer spread.

11. Basic principles of surgical treatment of paranasal sinus tumour

• Complete Resection: Aim for the total removal of the tumor with clear margins.

• Multidisciplinary Approach: Collaborate with specialists like neurosurgeons and plastic surgeons.

• Access and Approach: Choose between minimally invasive (endoscopic) or open surgical techniques based on tumor size and location.

• Reconstruction: Use reconstructive surgery to restore function and appearance after tumor removal.