OtoRhinoLaryngology Portal

The Leading Online Gallery of Otolaryngology and Head & Neck Surgery Specialty

OtoRhinoLaryngology Portal Video Collections @

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Neck Muscles Anatomy - Posterior Triangle, Prevertebral and Lateral Muscles

Neck Lump

The probable aetiologies of a neck lump in this area includes lymph nodes enlargement, branchial cyst, and parotid mass.  CT-scan and FNAC are usually carried out prior to its surgical intervention.

Swelling caused by benign parotid tumour.

Swelling caused by submandibular lymphangioma.

 

 Secondary infection of sub-vermilion border skin (arrow) which had occured upon traumatic shaving.  Submental lymphadenitis (ellipse) is visible and palpable as a tender swelling on the ipsilateral submental region.

Submental swelling and induration secondary to suppurative lymphadenitis.

 Kikuchi disease (histologically-confirmed) presenting with painful submental (arrow) and upper cervical lymphadenopathy.

Transillumination in Cystic Neck Swelling

Transillumination of cystic neck swelling caused by lymphangioma.  

[C- chin, M- mastoid tip, S- suprasternal notch]

Lymphangioma

CT-scan of neck in sagittal and axial plane showing a left-sided submandibular lymphangioma which was successfully removed surgically.

Thyroglossal Cyst

Thyroglossal cyst in a 9 year old child. 

Throglossal Cyst (In An Adult)

 

A well-defined central upper neck swelling.

 

Positive transillumination test.

 

 Markings after skin preparation and draping done intraoperatively.  [1 - midline at symphysis menti, 2 - hyoid bone level, 3 - skin crease incision line for exposure, 4 - superior thyroid notch, 5 - cricoid cartilage level, 6 - suprasternal notch]

 

 The cyst prior to delivery.

 The 'bed' of the cyst (*).  [T - thyroid cartilage.dot - central point of the superior thyroid notch, 1 - symphysis menti, 5 - cricoid cartilage level]

 Preoperative endolaryngeal view during phonation showing supraglottic narrowing (+) involving right false cord, petiole area, and diffuse bulge of right aryepiglottic fold.  [PF - pyriform fossa, PPW - posterior pharyngeal wall towards hypopharynx] 

 Preoperative endolaryngeal view during at rest showing supraglottic narrowing (+) involving right false cord, petiole area, and diffuse bulge of right aryepiglottic fold.  [PF - pyriform fossa, PPW - posterior pharyngeal wall towards hypopharynx]

 

Postoperative endolaryngeal view during phonation (A) and at rest (B) 24 hours after surgery showing dramatic improvement of supraglottic narrowinng.  Clinically, laryngeal innervations appeared intact and the patient's voice retured to normal.  NB: credit of this image to Dr. Tan Teck Soon.

Branchial Cyst

CT-scan slice in coronal view.  [(+) - cyst]

 

CT-scan slice in axial view.  [(+) - cyst]

 The typical location of the swelling (oval).

 The cyst in view (+).  The sternomastoid muscle being retracted laterally.

 

White dashed line - surface marking of sternomastoid muscle.

Applied Anatomy of The Thyroid Gland

Part 1

 

Part 2

 

Part 3

Thyroid Isthmus Mass

Thyroid isthmus mass(circle). Yellow dots- sternal ends of clavicles.

Thyroid Gland Movements Upon Swallowing

Thyroid swelling characteristically

moves up upon swallowing.

Left-sided goitre (+) made more prominent upon swallowing

Central goitre moves up upon swallowing.

 

 

Video of thyroid movement upon swallowing.

Grave's Opthalmopathy

Significant proptosis and conjunctival chemosis

The Recurent Laryngeal Nerve after Thyroidectomy

Figure shows right recurrent laryngeal nerve running alongside of tracheal wall.

Right recurrent laryngeal nerve (arrow) running in an angular course towards its destination behind the cricothyroid joint.  [T-trachea, RL-right thyroid lobe, LL-thyroid lobe]

Left recurrent laryngeal nerve (arrow) running in a more vertical course towards its destination behind the cricothyroid joint.  [S-superior, R-right, L-left, T-trachea, SH-sternohyoid muscle, SM-sternomastoid muscle,

C-cicothyroid muscle]

Healed thyroidectomy scar (arrows).

 

 Watch total thyroidectomy video @ YouTube

Watch another video of thyroidectomy @ YouTube

The Recurent Laryngeal Nerve Anatomical Relations During Total Laryngectomy

 

  H- head, T- thorax, S- sternomastoid, CA- common carotid artery, T- trachea,

E- oesophagus, TH- thyroid gland, arrow- recurrent laryngeal nerve.

An example of EMG endotracheal tube used for intraoperative recurrent laryngeal nerve monitoring in thyroid and parathyroid surgery.

Read more at Otolaryngology Houston

Total Thyroidectomy Specimen

 

Figure shows a large excised total thyroidectomy specimen in anatomical position.  The typical bosselated appearance of multinodular goitre is shown.

Retrosternal Goitre: CT-scan

Ectopic Thyroid in The Throat (Tongue Base)

 

Thyroid Cyst: CT-scan

 CT-scan axial view.

 CT-scan coronal view.

 CT-scan sagittal view.

 

A well-defined high attenuation lesion in upper pole of right thyroid lobe with possibilities of haemorrhagic cyst or infected cyst.

Thyroid Surgery & Its Complications

The Carotid Body Tumour

Superficial Cervical Lymphadenopathy

Tuberculous Cervical "Cold" Abscess

 Diagnostic aspiration of formed "cold abscess".  The fluid was sent for direct AFB smear, TB PCR and standard culture and sensitivity test.  TB PCR was found positive from the aspirated abscess.

 

 Close-up view of the fluid aspirated.

 

 Necrotic right supraclavicular lymphadenpathy (same patient) with dried scab (dotted circle). 

Mantoux Test

This is a diagnostic test of Tuberculosis. 

 

More Info: Wikipedia

          PDF

Watch video of Mantoux Test and Reading the PPD @ YouTube

 

 

 

Induration of forearm skin 72 hours after Mantoux test. 

 Positive Mantoux test (45 mm) in a patient presented with cervical lymphadenopathy of 3 weeks duration.

 An acute induration surrounding BCG scar in a child with Kawasaki disease.

 

 

Laryngeal evidence of haemoptysis in a patient with pulmonary tuberculosis.

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