Head and neck

A.Y. 2019/2020
9
Max ECTS
108
Overall hours
SSD
BIO/09 BIO/16 MED/28 MED/29 MED/30 MED/31
Language
English
Learning objectives
This course provides the students with the main knowledge regarding the diseases and the disorders that the physician should know in the head and neck district. The course integrates different disciplines, including basic disciplines, i.e. Anatomy and Physiology, and the main clinical disciplines relative to this complex area, i.e. Dentistry, Ear-Nose and Throat (ENT), Ophthalmology and Maxillofacial Surgery.The course focuses on the basic and clinical aspects of the Head and Neck pathologies. The course is designed in different blocks. In the first block anatomy and physiology lectures are preparatory to the clinical science lectures. Anatomy address the regional organization of the human head and neck, with a topographic approach in relation to clinical practice. Physiology addresses the sensory innervation of the oral-facial region and the principal head and neck related motor functions.
The basic science block are followed by clinical blocks, each one presenting a main topic, i.e. a symptom related to head and neck district. Taking the symptom as starting point, lectures disclose the possible mechanisms originating the symptom, driving the student in the differential diagnosis through a multidisciplinary integrated analysis of the different organs and systems of head and neck. Dentistry lectures aims to provide students with a comprehensive understanding of the common oral diseases, the relationship existing between oral and general health, and their prevention and treatment. Students are trained to recognise patients requiring interdisciplinary therapy in order to effectively interface with other specialties and disciplines in the care of patients. ENT lectures will focus on the different disorders in the ENT districts: clinical presentation and consequences of non-treatment and diagnostic means are discussed. Lectures highlight those diseases that overlap with the "neighboring" disciplines (e.g. odontogenic sinusitis) and discuss shared therapeutic options. Lectures of Ophthalmology provide a good background of knowledge about eye and vision related disorders, focusing on epidemiologically relevant diseases across different age groups. A final part focused on acute vision disorders and emergency completes the course. The lectures of maxillo-facial surgery focus, through the presentations of numerous clinical cases, on the epidemiologically most relevant craniofacial tumors and malformations, such as lip and palate clefts, craniofacial-stenosis and I and II arch syndromes. Special issue are held on reconstruction of post oncological and post traumatic facial defects. Lectures will also provide general knowledge on facial traumatology, focusing in particular on how to diagnose the most frequent fractures (nose, orbit, zygoma, maxilla and mandible) and how to practically handle simple or severe wounds involving facial soft tissues. Particular attention is given to facial paralysis: clinical description and facial surgical reanimation.
The final part of the course focuses on systemic respiratory and emorragic emergencies secondary to facial trauma will complete the course. Overall, the course encourages a multidisciplinary approach and try to integrate, whenever possible, all the features shared by the different specialties.
Expected learning outcomes
Students are expected to know:
- the anatomic-functional basis of head and neck related functions
- origin of pain in the head and neck area
The possible mechanisms originating the symptoms, differential diagnosis and clinical management of:
- nasal obstruction, epistaxis, oral mucosal diseases
- commonly prescribed medications and their significance for Oral Health
- movement Disorders: Facial Palsy, Dysphonia, Dysphagia, Dyspnoea, Ocular motion disorders
- loss of function: DEAFNESS, BLINDNESS
- neck and facial masses
- vertigo
- how pregnancy, growth and ageing affect the Head and Neck area
- distrectual expressions of systemic diseases and emergency
- facial and craniofacial disproportion
Course syllabus and organization

Unique edition

Prerequisites for admission
To take the Head and Neck exam, students must have already passed all the exams of the first and second year (Fundamentals of Basic Sciences, Cells, Molecules and Genes 1 and 2, Human Body, Functions and Mechanisms of Diseases).
Assessment methods and Criteria
Student assessment is based on a combination of written and oral examinations.
A written exam is a multiple-choice test focused on the topics of the Anatomy and Physiology modules. The professors and/or the IMS office informs via email the students about the results of the written test. Only students who successfully pass the written test are allowed to take the oral examination, focused on the modules: ENT, Ophthalmology, Odontostomatology, Maxillo-facial surgery. The final mark is the weighted average of the marks obtained in the oral examination.
The exam is deemed to be passed successfully if the grade is equal to or higher than 18/30 in all the disciplines of the oral examination. In the event of a full grade (30/30) honors (lode) may be granted with the consent of all the professors.
Registration to the exam through SIFA is mandatory.
Odontostomatological diseases
Course syllabus
INTRODUCTION TO THE COURSE
Lecture 0. Problems and symptoms in the Head and Neck patient

The patient with acute oral pain
The most common diseases of the oral cavity
Oral-facial chronic pain
The patient with oral mucosal diseases
Hypo-salivation and hyper-salivation
The patient with oral potentially malignant disorders and with oral cancer
Oral health issues of interest for the physician
Oral health is more than healthy teeth and gums
Teaching methods
Lectures, Clinical cases, Case studies and Laboratory skills. Practical activities will be used, through simulation or in the ward, to consolidate technical and soft knowledge and skills developed during frontal lectures.
Teaching Resources
· Peter Lockart Oral Medicine and Medically Complex Patients, 6th Ed, Wiley and Blackwell, 2013
Ophthalmology
Course syllabus
The red eye
The painful eye
Complications of oro-sinusal disease. What do we share with the ophthalmologist and maxillofacial surgeon?
Abnormal eye movements: the more common causes of diplopia: eye, visual system and neurologic disorders
The correct process of vision: the role of ocular media and their physiopathology
The blind eye: the more common conditions leading to complete blindness
The eye and the brain: the pathologies involving the visual pathways from the eye to the brain cortex
Orbital pathology: a multidisciplinary approach
The visual system in the child
The aging eye: Age-related conditions involving the anterior segment of the eye
The aging eye: Age-related conditions involving the posterior segment of the eye
What is a real emergency?
Surgical approaches for ocular diseases
Teaching methods
Lectures, Clinical cases, Case studies and Laboratory skills. Practical activities will be used, through simulation or in the ward, to consolidate technical and soft knowledge and skills developed during frontal lectures.
Teaching Resources
· Kanski's Clinical Ophthalmology, 8th Ed 2016 (Elsevier)
Otorhinolaryngology
Course syllabus
EAR NOSE THROAT The patient with nasal obstruction and/or nasal discharge
EAR NOSE THROAT The patient with headache - its relations with nasal disease
ENT, OPHTHALMOLOGY: Complications of oro-sinusal disease. What do we share with the ophthalmologist and maxillofacial surgeon?
The adult patient with dysphonia, dysphagia and/or dyspnea
The patient that does not hear
The patient with facial/cervical masses
To recognize the difference in handling a paediatric patient: The child
The patient with instability/vertigo
Teaching methods
Lectures, Clinical cases, Case studies and Laboratory skills. Practical activities will be used, through simulation or in the ward, to consolidate technical and soft knowledge and skills developed during frontal lectures.
Teaching Resources
· Probst, Grevers, Iro. Basic Otorhinolaryngology: a Step by Step Learning Guide (Thieme 2006)
Human physiology
Course syllabus
Somatosensory system: trigeminal district
Neural control of Face expression
Neural control of Masticatory function
Laryngeal functions
The neurophysiological basis of vertigo, nausea and vomiting
Teaching methods
Lectures, Clinical cases, Case studies and Laboratory skills. Practical activities will be used, through simulation or in the ward, to consolidate technical and soft knowledge and skills developed during frontal lectures.
Teaching Resources
· Papers provided during lessons.
Anatomy
Course syllabus
Headache related to disorders of the masticatory apparatus
Nose and paranasal sinuses
Peripheral Facial Palsy
Oro-pharyngeal Dysphagia
Voice disorders
Teaching methods
Lectures, Clinical cases, Case studies and Laboratory skills. Practical activities will be used, through simulation or in the ward, to consolidate technical and soft knowledge and skills developed during frontal lectures.
Teaching Resources
· Papers provided during lessons.
Maxillofacial surgery
Course syllabus
Oral nerve lesions are an emerging pathology, due to oral surgery increasing
The patient with facial/cervical masses
Facial and craniofacial Trauma
Traumatology of the facial skeleton
Clinical Examination and anthropometry of the face: facial and craniofacial malformation
Teaching methods
Lectures, Clinical cases, Case studies and Laboratory skills. Practical activities will be used, through simulation or in the ward, to consolidate technical and soft knowledge and skills developed during frontal lectures.
Teaching Resources
· Essentials of Oral and Maxillofacial Surgery - K Kahnberg, L Andersson, M Pogrel. Wiley-Blackwell 2014
· Peter Lockart Oral Medicine and Medically Complex Patients, 6th Ed, Wiley and Blackwell, 2013
Anatomy
BIO/16 - HUMAN ANATOMY - University credits: 1
Lessons: 12 hours
Human physiology
BIO/09 - PHYSIOLOGY - University credits: 1
Lessons: 12 hours
Professor: Cerri Gabriella
Maxillofacial surgery
MED/29 - MAXILLOFACIAL SURGERY - University credits: 1
Lessons: 12 hours
Professor: Biglioli Federico
Odontostomatological diseases
MED/28 - ORAL DISEASES AND DENTISTRY - University credits: 2
Lessons: 24 hours
Ophthalmology
MED/30 - OPHTHALMOLOGY - University credits: 2
Lessons: 24 hours
Professors: Fogagnolo Paolo, Rossetti Luca Mario
Otorhinolaryngology
MED/31 - OTORHINOLARYNGOLOGY - University credits: 2
Lessons: 24 hours