09. ENT & Skin Lesions PART-A COURSE MRCS (UK) Lecture Note
MRCS (UK) PART-A COURSE 09. ENT & Skin Lesions New Edition: February, 2023 About The DrAcademy The Best Medical Academy for Postgraduate Medical Exams of The Royal Colleges of UK. The DrAcademy [Experienced 12+years] is led by a group of talented doctors from all over the world & managed by a very skillful administrative staff. Our mission is to provide the best quality medical education with a very convenient fees structure to all the doctors who are preparing for MRCP (UK) | MRCS (UK) | MRCOG (UK) | MRCPCH (UK) | FCPS | MD | MS | PLAB & OET. Published by The DrAcademy � 25/2, Level-3, Green Road, Dhanmondi, Dhaka- 1205, Bangladesh � Web: www.thedracademy.com � Facebook: www.facebook.com/thedracademy ✉ Email:
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ENT + Skin Lesions Topics Overview Topic-01 | Parotid Gland Clinical.................................................. 1 Topic-02 | Disorders Affecting The Ear.......................................... 8 Topic-03 | Thyroiditis ............................................................... 11 Topic-04 | Voice Production ...................................................... 14 Topic-05 | Diseases Of Nose And Sinuses Benign.......................... 16 Topic-06 | Neck Lumps ............................................................. 20 Topic-07 | Thyroid Malignancy .................................................. 24 Topic-08 | Epistaxis .................................................................. 26 Topic-09 | Submandibular Glands-Disease................................... 28 Topic-10 | Secondary Haemorrhage After Tonsillectomy............... 30 Topic-11 | Hearing Loss ............................................................ 30 Topic-12 | Skin Disorders In Surgery- Malignancy And Related ...... 32 Topic-13 | Benign Skin Diseases ................................................. 35 Topic-14 | Skin Diseases............................................................ 39 Topic-15 | Sebaceous Cysts........................................................ 47 Topic-16 | Wound Healing ........................................................ 49
MRCS (UK) PART-A COURSE ENT & Skin Lesions Lecture Note The DrAcademy, 25/2 Green Road (Level-3), Dhanmondi, Dhaka-1205 Web: www.thedracademy.com | Office: +88-017 9905 0606 Helpline: +88-017 3355 2110 1 Topic-01 | Parotid Gland Clinical Benign neoplasms Up to 80% of all salivary gland tumours occur in the parotid gland and up to 80% of these are benign. There is no consistent correlation between the rate of growth and the malignant potential of the lesion. However, benign tumours should not invade structures such as the facial nerve. With the exception of Warthins tumours, they are commoner in women than men. The median age of developing a lesion is in the 5th decade of life. Benign tumour types Tumour type Features Benign pleomorphic adenoma or benign mixed tumor Most common parotid neoplasm (80%) Proliferation of epithelial and myoepithelial cells of the ducts and an increase in stromal components Slow growing, lobular, and not well encapsulated Recurrence rate of 1-5% with appropriate excision (parotidectomy) Recurrence possibly secondary to capsular disruption during surgery Malignant degeneration occurring in 2-10% of adenomas observed for long periods, with carcinoma ex-pleomorphic adenoma occurring most frequently as adenocarcinoma Warthin tumor (papillary cystadenoma lymphoma or adenolymphoma) Second most common benign parotid tumor (5%) Most common bilateral benign neoplasm of the parotid Marked male as compared to female predominance Occurs later in life (sixth and seventh decades) Presents as a lymphocytic infiltrate and cystic epithelial proliferation May represent heterotopic salivary gland epithelial tissue trapped within intraparotid lymph nodes Incidence of bilaterality and multicentricity of 10% Malignant transformation rare (almost unheard of) Monomorphic adenoma Account for less than 5% of tumours Slow growing Consist of only one morphological cell type (hence term mono) Include; basal cell adenoma, canalicular adenoma, oncocytoma, myoepitheliomas Haemangioma Should be considered in the differential of a parotid mass in a child Accounts for 90% of parotid tumours in children less than 1 year of age Hypervascular on imaging Obliteration of angle of mandible Below and behind the mandible. Member of MEN 1 Benign tumor but also may involve the Fascial nerve Usually not involve the Fascial nerve. Mx. Superficial parotidectomy( excise the gland superior to Fascial nerve ) for this reason it is called Mixed tumor ***** - **** -
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