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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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Trachea

Tumors Rare

Major Salivary Glands

ParotidSubmandibularSublingual

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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%

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