38 Questions
Which salivary gland disease is caused by the spread of infection?
Acute bacterial sialoadenitis
What is a possible complication of untreated acute bacterial sialoadenitis?
Septicaemia
What is a characteristic of pleomorphic adenoma?
It rarely transforms into a malignant tumor
What is the main cause of salivary calculi?
Obstruction
What is a possible route of metastasis for parotid carcinoma?
Lymphatic spread to submandibular LNs
What is a characteristic of adenolymphoma?
It is also known as Warthin's tumor
What is a possible complication of untreated salivary calculi?
Sialoadenitis
What is the most common type of salivary gland tumor?
Pleomorphic adenoma
What is the typical appearance of the tumor in the given pathology?
Greyish formation with whitish areas and multiple cystic spaces
What is the primary reason for early decompression in the treatment of this pathology?
To alleviate severe pain due to pressure
What is the characteristic of the stroma in this pathology?
It is pale blue and full of lymph follicles
What is the most common type of carcinoma in this pathology?
Mucoepidermoid carcinoma
What is the composition of the stones in this pathology?
Ca and Mg carbonate
What is the consequence of not performing early decompression?
Severe pain and rapid necrosis
What is the characteristic of the epithelial cells in this pathology?
They are columnar and squamous in shape
What is the outcome of the tumor's growth in the parotid gland?
Major destruction of the parotid gland
What is the characteristic of the opening of the duct in the oropharynx?
It is red, raised, and oedematous
How is the bulge in the oropharynx better felt?
From inside the mouth
What is a possible manifestation of malignant transformation in the patient?
Loss of hypoglossal and lingual nerve function
What is a possible finding in the draining lymph nodes?
They are enlarged and soft
What is a possible cause of the swelling in the oropharynx?
A stone in the duct
What is the significance of the unequal superficial shift of the tonsil medially?
It is a sign of a malignant transformation
What is the primary method of assessment for pleomorphic adenoma?
CT scan and MRI
What is the primary purpose of sialendoscopy in salivary gland diseases?
Diagnostic and therapeutic
What is the characteristic of adenolymphoma on a technetium 99 scan?
Hot areas
What is the primary method of diagnosis for clinically benign tumors?
FNAC
What is the primary purpose of prophylactic measures in salivary gland diseases?
To prevent stone formation
What is the characteristic of salivary stones on a plain X-ray?
80% are radio-opaque
What is the primary method of diagnosis for acute bacterial sialoadenitis?
Culture and sensitivity of the pus
What is the significance of leukocytosis in acute bacterial sialoadenitis?
It is a sign of infection
What is the primary purpose of a preauricular skin incision in parotidectomy?
To avoid injury of superficial temporal vessels and auriculotemporal nerve
What is the benefit of making a 2 cm incision parallel to the lower border of the mandible in submandibular sialadenectomy?
To preserve the mandibular branch of the facial nerve
What is the primary indication for palliative excision and radiotherapy in salivary gland tumors?
Inoperable cases
What is the purpose of Hilton's method in parotidectomy?
To split the parotid fascia in a transverse direction
What is the benefit of sialendoscopy in the management of salivary gland stones?
To remove duct stones
What is the primary indication for total radical sialadenectomy?
Highly malignant tumors
What is the primary structure to be preserved during submandibular sialadenectomy?
Mandibular branch of the facial nerve
What is the purpose of ESWL in the management of salivary gland stones?
To treat salivary stones
Study Notes
Capsulated Tumor (Mucoepidermoid Carcinoma)
- Contains non-capsulated greyish formation with whitish areas (epithelial) and multiple cystic spaces lined by epithelial cells and filled with mucoid material
- Stroma is pale blue with mucinous and myxomatous tissues
- Can cause severe pain and rapid necrosis, followed by recurrence
Adenoid Cystic Carcinoma
- Commonest malignancy in minor salivary glands
- Composed of multiple cystic spaces lined by epithelial cells and filled with mucoid material
- Stroma is pale blue with mucinous and myxomatous tissues
Pleomorphic Adenoma
- Rarely malignant transformation after 10-20 years
- Recurrence possible after removal due to defect in the capsule
Adenolymphoma (Warthin's Disease)
- Never turns malignant
Acute Bacterial Sialoadenitis
- Spread of infection can cause septicaemia, toxaemia, and pyaemia
- Locally causes cellulitis and acute abscess
- The opening of the duct is red, raised, and discharging pus or blood
- Investigation: blood picture shows leucocytosis, culture and sensitivity for pus coming from duct
Salivary Calculi
- Obstruction can cause sialectasis
- Investigation: ultrasound shows all salivary stones, plain X-ray shows 80% of stones are radio-opaque, sialendoscopy is diagnostic and therapeutic
Investigations
- C.T scan and MRI are most useful methods for assessment and show the extent of the tumor
- FNAC is a reliable method for diagnosis
- Excision biopsy and frozen section during operation are essential for clinically malignant tumors
- Technetium 99 scan: adenolymphoma shows hot areas, while other salivary tumors give cold areas
- Sialography shows sialectasis or filling defect in radiolucent stones
Treatment
- Prophylactic: proper hydration and oral hygiene
- Clinically benign tumors: conservative parotidectomy
- Clinically malignant tumors: total radical sialadenectomy, ESWL is used nowadays to treat submandibular salivary stones
- Inoperable cases: palliative excision, radiotherapy
This quiz covers the characteristics of a capsulated tumor in the parotid gland, including its appearance and composition. It also touches on the parotid fascia and possible necrosis.
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