Head And Neck

1. Head and Neck Head And Neck Walid Galal El Shazly MD of General Surgery Lecturer of Colorectal Surgery

2. Salivary gland Tumours • Epithelial • Benign • Pleomorphic adenoma (Mixed parotid) • Monomorphic adenoma Adenolymphoma, oncocytoma • Malignant • Primary • Acini Adenocarcinoma,adenoid cystic,acinic cell carci • Ducts Mucoepidermoid High grade squamus cell carcinoma Low grade 10 times more comon • Mixed malignant mixed salivery • Secondary rare • Stromal • Benign hemangioma, neurofibroma • Malignant sarcoma, lymphoma

3. Incidence of Salivary tumors • Role of 80% • 80% of salivary tumors develop in the parotid • 80% are benign • 80% of bengin are mixed salivery • Incidence of malignancy increase as the size of the gland decrease Parotid 20%, Submandibular 50%,Minor salivary 75%

4. Mixed Salivary tumors( pleomorphic adenoma) • Incidence: • 60% of all salivary tumors • 25-50 y ,females more, superficial lobe more • Clinical picture • Painless swelling over the angle of the mandibule anterior to ear lobule • Swelling very slowly growing, well defined, rounded, painless, smooth , lobulated,firm and mobile

5. Salivary neoplasm( pleomorphic adenoma)

11. Adenolymphoma • Incidence • Second common benign,97% in parotid • Over 40y, more in male,bilateral 10% • Pathology • It is a hamartoma,inclusion of the parotid gland duds (ducts) into the LN near the parotid • Cystic spaces,lined by epith,embeded in lymphoid matrix • Clinical picture • Painless sweeling in the parotid area,more mobile,soft even cystic,no invasion • Treatment • Superficial parotidectomy

12. Adenolymphoma

13. Malignant salivary tumors • Incidence • The most common is • the Mucoepidermoid in the parotid • Adenoid cystic carcinoma in other glands • Age more in old age ,except adenocarcinoma in children • Sex male and female equal • Male squamous cell carcinoma is more • Female malignant mixed salivary is more

14. Carcinoma of the Parotid • Squamus cell carcinoma • The commonest • Signs of malignancy • S size recent rapid increase in size • C hard on consistancy • E irregular edges • P pain • M limited mobility • Invade • skin ulcer • Facial nerve • Superficial temporal artery • Muscles and bones • Cervical LN

16. Malignant tumors

21. DD (lipoma)

22. Osteosarcoma bones

23. Hemorrhagic cyst in the parotid

24. parotedectomy

26. Superficial parotidectomy

33. Total Parotidectomy