The key points are:
1. Tumors of the parapharyngeal space can be divided into those originating from salivary glands (most common), nerves, and other miscellaneous sources.
2. Imaging such as CT and MRI are important for diagnosis and determining the relationship to surrounding structures like blood vessels.
3. Surgical excision is usually the primary treatment, with the approach depending on factors like location and size of the tumor.
4. Observation or radiation therapy may be considered for patients who are not surgical candidates or if the tumor is not resectable.
Cavity obliteration is a procedure done at the end of Mastoidectomy to get a cavity-less mastoid cavity thus solving the problem of discharging post-operative cavity.
Spaces of middle ear and their surgical importanceDr Soumya Singh
one of the imp topics in ENT that should be understood very thoroughly if u want to pursue as an otologist.I tried to simplify the topic with simple diagrams and models for better understanding .
Cavity obliteration is a procedure done at the end of Mastoidectomy to get a cavity-less mastoid cavity thus solving the problem of discharging post-operative cavity.
Spaces of middle ear and their surgical importanceDr Soumya Singh
one of the imp topics in ENT that should be understood very thoroughly if u want to pursue as an otologist.I tried to simplify the topic with simple diagrams and models for better understanding .
This is a presentation I used for my seminar on 'Phonosurgery' on 4th November, 2015. I hope they are useful to you. Constructive as well as Destructive criticism welcomed.
This is a presentation I used for my seminar on 'Phonosurgery' on 4th November, 2015. I hope they are useful to you. Constructive as well as Destructive criticism welcomed.
Maxillectomy and craniofacial resection Mamoon Ameen
all maxillectomy types in detail and maxillofacial resection ,indications ,contraindications ,preoperative asssessment and detail techniques and rehabilitations
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
2. INTRODUCTION
• less then 1% of Head and neck neoplasms
• 70-80% are benign
• Radiological imaging very important for diagnosis
• Surgical excision is the primary treatment
• Morbidity of surgery should be considered along with natural history of disease in making a
treatment plan
14. Salivary Gland Tumors
• Most common PPS neoplasms: 40-50%
• Pleomorphic adenoma 80-90%
• Mucoepidermoid most common malignant
• Less than 5% parotid tumors involve the PPS
15. Salivary Gland Tumors
• Located in prestyloid space
• From deep lobe of parotid or minor salivary glands
• On CT or MRI a fat plane between the parotid and a prestyloid mass indicates minor salivary
gland origin
• Displace the internal carotid posteriorly
17. Schwannoma
• Most common neurogenic neoplasm
• Vagus, sympathetic chain most common
• Benign and slow growing
• Generally don’t affect nerve of origin
• Less than 1% malignant
• Displace internal carotid anteriorly
18. Paraganglioma
Second most common
Highly vascular
Arise from vagus , carotid body, jugular bulb
• Bilateral 10%, familial 30%
• Part of MEN IIA or IIB (medullary thyroid carcinoma,
pheochromocytoma, parathyroid hyperplasia-with or
without mucosal neuromas)
19. • Secrete catecholamines 1-3%
• Malignant 3-10%
• Classically, paragangliomas mobile anterior-posterior but not up and down
• Glomus vagale displace carotid anteriorly
• Carotid body tumors splay internal and external carotid – “lyre” sign
20. Neurofibromas
• 3rd most common neurogenic tumor
• From Schwann cells and fibroblasts
• Unencapsulated (involve nerve)
• Multiple
• Part of Neurofibromatosis type I
23. Evaluation
Detailed history
Complete head and neck examination
Pulse and blood pressure
Cranial nerves
Bimanual palpation
Bruit, thrill
IDL
Neither AJCC nor International union
against cancer have given any staging for
pps tumor
24. Investigations
FNAC
Ultrasound guided
CT-guided FNAC procedures are essential for lesions that are not directly detectable without
imaging techniques
25. Special investigations
24-hour urine collection for catecholamines
Vanillylmandelic acid (VMA)
Metaiodobenzylguanidine scan (MIBG)
27. CT
Locates tumor to prestyloid vs postyloid
Fat plan between mass and parotid
Displacement of carotid artery
Enhancement of lesion
Bone erosion
Limited soft tissue detail -MRI
28.
29.
30.
31.
32.
33. MRI
Most useful study
Relationship of mass and other soft tissue and carotid more easily seen than with CT
Characteristic appearance of tumor types on MRI allows preoperative Dx 90-95% of patients
34.
35.
36.
37.
38. Angiography
Used to all enhancing lesions
Gold standard for relation ship to blood vessels
Differentiate neurogenic and vascular
Main indication is planning for surgical treatment
Balloon occlusion test
41. Surgical Rx
Preoperative workup
Pre.op. counselling
Preoperative embolization of tumors > 3cm size with obvious feeding vessel
Functioning paragangliomas should be identified and pre op alpha and beta blockers should be
given
42. Surgical approaches
Depends on location. Size , suspicion of malignancy ,relationship to neurovascular
structures, surgeon experience
Goal is to achieve optimal exposure and vascular control without significant
morbidity
44. Transoral
Has been used for small, benign , prestyloid tumor
Very limited exposure
Increased risk of tumor rupture and spillage,
Risk of injury to neurovascular structure
Not recommended
45. Transcervical
Reserved for pre and post styloid tumors
Transverse incision at level of hyoid
Submandibular gland displaced or removed
Digastric muscle retracted or its tendon is divided
46.
47.
48.
49.
50.
51. Transparotid
For small deep lobe parotid tumors
Superficial parotidectomy
Division of stylomandibular ligament
Dissect around mandible
May use mandibulotomy
52. Transcervical-parotid
Deep-lobe parotid tumors with PPS extension
Extend cervical incision up infront of ear
identification facial nerve
Divide posterior belly digastric
Divide stylomandibular ligament, styloglossus, stylohyoid
close to styloid process
53. Transmandibular Approaches
Both the lateral mandibulotomy and the median mandibul-
otomy-transpharyngeal approach
Very large tumors
Malignancy
Vascular tumors extending to skull base
Need a tracheostomy
54. infratemporal fossa approach
Preauricular lateral infratemporal fossa approach
Skull base or infratemporal fossa involvement
55. Transcervical-transmastoid
Cervical incision carried postauricularly
Mastoidectomy
Remove mastoid tip exposing jugular fossa
Facial nerve may need to be dissected from Fallopian canal
56. Nonsurgical Management
Poor surgical candidates, failed balloon occlusion, elderly, unresectable lesions,
would require sacrifice of multiple cranial nerves
• Observation for stable tumor
• Radiation for growing tumor
57. Observation
Benign and asymptomatic
Paragangliomas grow 1 -1.5 mm per year
Mortality less than 10% per year for untreated
58. Radiation
Not used for cure
Arrest the growth
Metastatic tumor
Postoperative irradiation is recommended for high-grade malignancies or when wide surgical margins cannot
be obtained.