1

Infections

Nasal CavityParanasal Sinuses

ViralBacterial

2

3

Polyp

Any growth protruding from mucous membrane

4

Polypoid LesionsNasal Cavity, Paranasal Sinuses

1. Inflammatory polyp2. Benign tumors3. Malignant tumors

5

6

7

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

8

9

10

Papillomatosis

A. Human Papilloma Virus

B. Recurrences: 50 – 70%Multiple RecurrencesInvasive Carcinoma: 5%

11

1. Uncommon2. Papillomatosis3. Chronic infections4. Wood workers5. Nickel smelting6. Thorotrast

CarcinomaNasal Cavity, Sinuses

12

1. Polyp, mass2. Obstruction3. Epistaxis4. Pain

CarcinomaNasal Cavity, Sinuses

13

A. Destructive lesions nasal cavity, sinuses

B. Perforation, nasal septum

C. Collapse, nasal bridge

Lethal Midline GranulomaMidline Granulomatous Disease

14

Malignant lymphomasWegener’s GranulomatosisCarcinomaSyphilisTBC, Leprosy, FungusCocaine Sniffing

Lethal Midline Granuloma

15

1. Hyperplastic lymphoid tissue: Nasopharynx

2. Difficulty breathing3. Middle ear infections

Adenoids

16

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

17

18

1. Common2. Children3. Tympanic membrane ruptures4. Chronic otitis media5. Mastoiditis6. Myringotomy

Middle Ear Infections(Acute, Chronic Otitis Media)

19

1. Chronic otitis media2. Cuboidal epithelium replaced

by squamous epithelium3. ? Metaplasia

? Ingrowth4. Keratin: Mass5. Destruction of ossicles

Cholesteatoma

20

1. Nasopharynx2. Tonsils3. Lingual tonsils4. Uvula, pharynx5. Hypopharyx

Waldeyer’s RingLymphoid Tissue

21

22

Squamous cell carcinoma

Oral cavity, oropharynxPharynx, hypopharynxEsophagus

Smoking, drinking

23

Tumors: pharynx

1. Dysphagia2. Ulcers, masses3. Unilateral tonsillar swelling4. Squamous cell carcinoma

24

25

Polyps of Vocal Cord

1. Common2. Hoarseness3. ? Voice abuse4. Polypectomy

26

Papillomas: Larynx

Young peopleHoarsenessHuman Papilloma Virus

27

Leukoplakia

1. HyperplasiaHyperkeratosis

2. Dysplasia3. In situ carcinoma4. Invasive carcinoma

28

Squamous Cell CarcinomaLarynx

1. 10,000 new cases / year2. Heavy smoking3. Vocal apparatus:

hoarseness4. Supraglottic area: large;

dysphagia

29

30

31

Trachea

Tumors Rare

32

33

Major Salivary Glands

ParotidSubmandibularSublingual

34

“Minor” Salivary GlandsSerous and Mucous GlandsNasal CavityParanasal SinusesNasopharynxOral CavityPharynxEsophagusLarynxTracheaBronchi

35

36

37

Salivary Gland Tumors

Parotid: 75%Submandibular: 10%Sublingual: rareMinor salivary glands 15%

38

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%

39

40