Head and Neck Onco 18-40

Ans 21 ) c II - VI

 Petrosphenoidal syndrome of Jacob – includes unilateral trigeminal neuralgia ( v) , unilateral ptosis(III)  complete ophthalmoplegia ( III, IV, VI)  and amaurosis – ( CN II)  by IC extension

Ans 22) b Inferior Alveolar nerve

Complications of submandibular gland excision
● haematoma;
● wound infection;
● marginal mandibular nerve injury;
● lingual nerve injury;
● hypoglossal nerve injury;
● transection of the nerve to the mylohyoid muscle producing submental skin anaesthesia.

Ans 23) a

Oral tongue SCC is increasingly regarded as a biologically different entity compared with cancer affecting other oral sites, with it  being more aggressive and generally associated with a higher rate of metastasis.

The high propensity for subclinical occult nodal metastasis associated with early tongue cancer has been well studied. The incidence of subclinical occult nodal metastasis on initial presentation in patients with cT1N0 or cT2N0 OTSCC who underwent END ranged from 8.2% to 46.3%, with a mean incidence of 25.9%

See this Ref 

For all  oral cavity 

Management of the neck for oral cavity cancer depends on the presence or risk of regional metastases;

early-stage oral cavity SCC, when the DOI is larger than 3 mm, an elective neck dissection

The extent of neck dissection can be either a selective supraomohyoid neck dissection (levels I–III) for a clinically N0 neck or up to a modified RND (sparing all muscular and neurovascular structures if possible) for cN+ disease.

If the primary tumor crosses the midline, bilateral neck treatment should be performed.

Sabiston 21 page 788