HEAD AND NECK DISEASES

FRANCES VIDA A. PORSUELO-ESPINO, MD

3RD YEAR RESIDENT
TOPIC OUTLINE
1. General ORL

2. Nose, Paranasal Sinus, and Nasopharynx

3. Laryngology

4. Craniomaxillofacial trauma

5. Otology

6. Head and Neck Oncology

GENERAL OTORHINOLARYNGOLOGY
1. ODONTOGENIC INFECTIONS

2. PHARYNGITIS

3. DEEP NECK SPACE INFECTIONS

ODONTOGENIC INFECTIONS

ETIOLOGY: carious tooth or tooth

suffering from periodontal disease

Most common:
streptococci and oral anearobes
ODONTOGENIC INFECTIONS
ODONTOGENIC INFECTIONS

MANAGEMENT:
• ENDODONTIC THERAPY OR EXTRACTION OF THE TOOTH,
SURGICAL DRAINAGE OF THE ABSCESS, AND RELEASE
OF PRESSURE TO IMPROVE VASCULARITY
• AIRWAY ESTABLISHMENT
• DOC: PARENTERAL PENICILLIN
 PHARYNGITIS

Inflammation of the
pahrynx

Predominant symptom
is SORE THROAT
PHARYNGITIS: SORE THROAT

5-10% ADULTS
30-40% CHILDREN
PHARYNGITIS
DEEP NECK SPACE INFECTIONS
FACE
buccal, canine,
masticator, parotid
SUPRAHYOID
peritonsillar,
submandibular,
sublingual,
parapharyngeal
INFRAHYOID
anterior visceral
LENGTH OF NECK
retropharyngeal,
danger, prevertebral,
carotid
DEEP NECK SPACE INFECTIONS

 Adults: dental infections, oropharyngeal infections

 Children: acute bacterial tonsillitis and pharyngitis

 the infection may spread from its portal of entry to other

regions of the neck through
 the lymphatic system
 arterial or venous channels
 direct extension between spaces and along fascial planes
DEEP NECK SPACE INFECTIONS

Streptococcus viridans
Staphylococcus epidermidis
Staphylococcus aureus
group A beta-hemolytic Streptococcus
Bacteroides
Fusobacterium
Peptostreptococcus species
Neisseria, Pseudomonas, Escherichia, Haemophilus species
Methicillin- resistant Staphylococcus aureus (MRSA)
DEEP NECK SPACE INFECTIONS

MANAGEMENT:

 Evaluation and maintenance of the airway

 Intravenous antibiotics
 Fluid rescucitation
SLEEP APNEA AND SLEEP DISORDERS
SLEEP APNEA AND SLEEP DISORDERS
SLEEP APNEA AND SLEEP DISORDERS

• sound generated by the vibration of

the pharyngeal soft tissues

• sequence of breaths over at least 10

seconds with increasing respiratory
effort that terminates with an arousal

• five or more respiratory events

(apneas, hypopneas, or RERAs) in
association with excessive daytime
somnolence
SLEEP APNEA AND SLEEP DISORDERS

POLYSOMNOGRAPHY
 GOLD STANDARD FOR DIAGNOSIS OF OSA
Nose, Paranasal Sinus, and
Nasopharynx
EPISTAXIS
EPISTAXIS
EPISTAXIS
EPISTAXIS

TERMINAL
BRANCHES OF
EXTERNAL AND
INTERNAL
CAROTID
ARTERIES SUPPLY
THE NASAL
MUCOSA
EPISTAXIS

ANTERIOR:
LITTLE’S OR
KIESSELBACH’S
AREA

POSTERIOR:
SPHENOPALATIN
E ARTERY
RHINOSINUSITIS

•Sudden onset
•Duration of less than 4 weeks

•At least 12 consecutive

weeks duration

•Acute flare-up of CRS

RHINOSINUSITIS
RHINOSINUSITIS
RHINOSINUSITIS
BENIGN TUMORS OF SINONASAL
TRACT

 MOST COMMON: OSTEOMA

 2ND MOST COMMON: INVERTED PAPILLOMA

BENIGN TUMORS OF SINONASAL
TRACT
BENIGN TUMORS OF SINONASAL
TRACT
BENIGN TUMORS OF SINONASAL
TRACT
LARYNGOLOGY
BENIGN VOCAL FOLD MUCOSAL
DISORDERS
BENIGN VOCAL FOLD MUCOSAL
DISORDERS

 VOCAL NODULES

 CAPILLARY ECTASIA

 HEMORRHAGIC VC POLYP

 INTRACORDAL CYST
CRANIOMAXILLOFACIAL TRAUMA
OTOLOGY
HEAD AND NECK ONCOLOGY