Art. Supply of the tonsils

Lymphatic drainage of pharynx

Sphincters of pharynx Cricopharyngeus Laryngeal inlet Velopharyngeal Oropharyngeal

Constrictors of oesophagus

Mouth ulcers esp. AIDS, aphthous

EBV Hairy leucoplakia Inf. Mononucleosus Nasopharyngeal carcinoma

Rationale of ttt of pharyngitis Eradication of infection Relief of symptoms

Disease and its organism

Upper resp. tract inf. …………… pneumo, H. infleunza, maroxella

Nerve supply of pharynx & refered otalgia

Operations & Cr. NervesOptic n.

FESS

Trigeminal (infraorbital n.) Radical antrum

Facial n. Mastoidectomy , superficial parotectomy , stapedectomy, vestibular neurectomy & acaustic neuroma

cochlear n. acaustic neuroma

glossopharyngeal tonsillectomy

vagus (rec. laryngeal) thyroidectomy

spinal part of accesory radical neck dissection

hypoglossal submandibular sialadenecomy

lower 4 cr. N op. of nasopharyngeal carcinoma

rationale of abcess ttt same of inf. + evacuation of pus by:

incision & drainage in acute excision in chronic

characters of malignant L.n

rationale of investigating tumour diagnosis grading (histopathological : e.g well differenciated) staging : TMN

N.B we detect lymph node metastasis by CT

Rationale of ttt of malignant tumour Management principle

Remove tumour completely Preserve function

Management plan (mention according to tumour) Prognosis is bad due to

Late diagnosis Major operations with major complications

Barium swallow …………. PharynxBarium meal ……………... stomachBarium enema ……………. Colon

10 + 7 = 12 + 5

10th & 7th cr. N …………………… paralysis lead to deviation to the healthy side12th & 5th cr. N …………………… paralysis lead to deviation to the diseased side because of pushing of the healthy muscles

radical neck dissectionall structures are removed

functional neck dissectionthe following are preserved:

sternomastoid int. jugular spinal part of accesory

N.B ligation of ext. carotid is between sup. Thyroid and lingual branches