ENT Head and Neck Oncology Flashcards

Which chemotherapy agent is most commonly used as a radiosensitizer in concurrent chemoradiation for locally advanced head and neck SCC?

Answer: Cisplatin

Cisplatin-based concurrent chemoradiation is the standard of care for locally advanced, unresectable head and neck SCC, administered as high-dose bolus every 3 weeks as a radiosensitizer.

Which cranial nerve is most commonly injured during total thyroidectomy, resulting in hoarseness?

Answer: Recurrent laryngeal nerve (branch of CN X)

The recurrent laryngeal nerve is the most commonly injured nerve during thyroidectomy; unilateral injury causes ipsilateral vocal cord paralysis and hoarseness, while bilateral injury may require tracheostomy.

Base of tongue (BOT) squamous cell carcinoma is most commonly associated with which etiology in the US?

Answer: HPV infection (HPV-positive oropharyngeal SCC)

Base of tongue SCC is a major subsite of HPV-positive oropharyngeal squamous cell carcinoma in the US, most commonly caused by HPV-16 and typically presenting with a neck mass from nodal metastasis.

Glomus jugulare tumors (paragangliomas) at the skull base are best described as:

Answer: Highly vascular, slow-growing tumors arising from paraganglia near the jugular bulb

Glomus jugulare tumors are highly vascular paragangliomas arising from paraganglia near the jugular bulb; they grow slowly and present with pulsatile tinnitus and lower cranial nerve deficits (CN IX–XII).

Which staging system feature distinguishes oral cavity SCC from oropharyngeal SCC in the AJCC 8th edition?

Answer: Oral cavity SCC is staged using depth of invasion (DOI), while oropharyngeal SCC uses HPV/p16 status

AJCC 8th edition incorporates depth of invasion (DOI) into T-staging for oral cavity SCC, while oropharyngeal SCC has a separate p16-positive (HPV-driven) staging pathway with a more favorable stage distribution.

Which sign on examination of a posterior pharyngeal wall tumor suggests prevertebral fascia invasion and unresectability?

Answer: Tumor fixation to the cervical spine during swallowing

Fixation of a posterior pharyngeal tumor to the cervical spine during swallowing indicates prevertebral fascia invasion, making clear surgical margins unachievable and the tumor unresectable.