this presentation discusses how to approach to the neck mass
and important DDx according to the site and age of onset
with clinical points about important etiologies
cavernous sinus thrombosis,help for Otolaryngology trainees,ENT specialist and general practitioners also.anatomy,cause,pathology,investigation,treatment included.
guideline for long case presentation,include history,examination,,investigation,treatment option,surgical procedure of superficial parotidectomy,short discussion about plemorphic adenoma
Rhinisinusitis bullet point,type,causative organism,investigation,treatment
quick overview ,easy understanding
ref:Scott-Brown's Otorhinolaryngology and Head and Neck Surgery
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
2. NECK MASS
Neck mass may be defined as any abnormal
enlargement, swelling or growth from the level of base
of skull to clavicles
Neck
mass
Midline
Lateral
3. Age in relation to possible neck swelling
Child
(0–15years)
Young adult
(16–35years)
Adult
(35 years +)
Congenital Cystic hygroma
Thyroglossal
duct cyst
Branchial cyst Very uncommon
Inflammatory Very common common Rare
Salivary disease Inflammatory Sialolithiasis Neoplasms
Thyroid disease Uncommon
Malignancy
Papillary
carcinoma
Thyroid malignancy
Neoplasms Rare Lymphoma
Squamous cell
carcinoma
Metastases
Lymphoma
Metastases
4. Lateral neck mass
1)Submandibul Triangle
2)Anterior triangle
3)Posterior triangle
• Reactive lymphadenopathy(younger age group)
• Neoplastic lymphadenopathy(older age group)
• Submandibular gland disease-
sialadenitis,sialolithiasis,neoplasm
• Reactive lymphadenopathy or lymphoma(younger age group)
• adenopathy(TB,HIVtoxoplasmosis,actinomycosis)
• Neoplastic lymphadenopathy(firm,non-tender,lymphoma or
Squamouscell carcinoma)
• Branchia lcyst(2nd-3rd decades)
• Thyroid masses
• Parotid gland disease-sialadenitis,cysts,sialolithiasis,neoplasm
• Paraganglioma-carotid body tumor,glomus vagale
• Laryngocoele(enlarges with blowing)
• Cystic hygroma/lymphangioma
• Neoplastic lymphadenopathy(firm,non-tender,older age group)
6. Branchial cyst
Congenital cystic swelling- 2nd branchial cleft anomaly
60% cyst are located in upper third of neck ant margin
sternocleidomastoid muscle at carotid triangle
Pt present as painless swelling upper part of neck
Lined by squamus epithelium containing sebaceous materials.
Painful if infected
7. Investigation
USG
FNAC-FNAC yields acellular fluid that rich in cholesterol crystals
CT scan of neck
Treatment
Surgical excision of the cyst with complete sinus tract
If infected – Antibiotics +/- Needle aspiration followed by excision
CT scan shows - well-circumscribed, non-enhancing mass of
homogenous low attenuation. Wall thickening and
enhancement may occur due to associated inflammation
8. Cystic Hygroma
Cystic hygromas are the most common form of lymphangioma
75% occur in the neck
malformations of the lymphatic system that usually present as
a posterior neck swelling
Swelling is soft. Cystic Multiloculated lined by lymphatic
vessels containing lymphatic fluids
It may be infected as a result of nasopharyngeal infection
9. Investigation
USG
FNAC
CT/MRI
Treatment
surgical excision
CT - poorly circumscribed, multi-loculated, hypodens
masses with fluid attenuation. cystic mass (arrows) in
the posterior triangle of left side of neck in a 3 month old
child
10. Laryngocele
Laryngocele is considered to have a congenital
derivation, usually manifests in adults.
It is dilatation of the laryngeal ventricle,
A laryngocele may become infected and is then called
a laryngopyocele.
Swelling enlarge by increase intra laryngeal pressure,
staining, coughing
11. Investigation
Soft Tissue X-ray Neck/CT Imaging Of Larynx
during Valsalva Maneuver
Direct Laryngoscopy
Treatment
Excision Of Cyst by Microlaryngoscopy
Or external Approach
Axial contrast-enhanced CT image shows air
filled internal laryngocele (arrow) on
the right
12. Ranula
Represent cystic lesions of the floor of the mouth
Usually occurring secondary to obstruction of the
sublingual duct. Therefore these are also called
sublingual gland mucocele or mucous retention cyst.
Ranula may be either
Simple” and confined to the sublingual space .
Deep/Plunging-extend into the neck
Bimanual palpation will reveal cross fluctuation
between floor of the mouth and its cervical extension
13. Treatment
Total excision along with removal of sublingual gland
Axial contrast-enhanced CT scan shows a cystic attenuation
lesion(arrows) in the floor of the mouth
14. Carotid body tumor
Located at bifurcation of common carotid artery
It forms a slowly growing painless hard ovoid lobulated
swelling
Moves laterally not vertically
Peoples lives in high altitude or suffering from chronic
hypoxia stimulation chemoreceptor
A few pt complaints attack of faintness on pressure
over lump-carotid body syncope
Regional metastasis occurs 1/5th of cases & distant
metastasis is almost unknown
15. Investigation
Contrast Enhance CT And MRI With Gadolinium Is Diagnostic
MRI angiography
FNAC or biopsy should not be done because of vascularity
Treatment
Surgical excision
Radiotherapy
MRI angiography shows extend of carotid tumor
16. Sternomastoid tumor
A swelling in middle third of sternomastoid muscle
results from birth trauma
Circumscribe firm mass within the muscle
The lesion is self-limiting and benign, usually resolving
with time and physical therapy.
Rarely it need to be removed surgically. Surgery is
performed on patients in whom torticollis persists for 1
year.
18. Tubercular lymph node
Mass due to TB lymph node in neck is very common in
our country
Involved lymph node may be single, multiple or
matted due to periadenitis.
Tubercular abscess developed when node caseation
occurs.
19. Investigation
FNAC/lymph node biopsy
AFB & c/s from aspirated material
Mantoux test
CT/MRI
Treatment
Anti tubercular drug regiment
Surgical excision when drug treatment fails.
20. Lymphoma
Malignant tumor of lymphatic tissues
Both Hodgkin’s & non- Hodgkin’s lymphoma
present with cervical lymphadenopathy
Can occur at any age
Presents with painless, rubbery lymphadenopathy
Systemic symptoms such as fever, night sweats, fatigue, and weight
loss may occur, and hepatosplenomegaly is an associated finding
Excision biopsy is often required to confirm diagnosis
Treatment is chemo/radiotherapy
