This action might not be possible to undo. Are you sure you want to continue?
Lips to the junctional of hard and soft pallate Mucosa buccal Upper and lower alveolar bridges Retromollar trigone 2/3 oral tongue Floor mouth Hard palate
Risk factor alcohol, tobacco 95% Ca sel skuamosa Pria : Wanita = 1:2 95% > 40 tahun; umur rata-rata 60 tahun the human papillomavirus (HPV) may play a role in the etiology of oral cavity
tetapi hubungannya belum jelas karena leukoplakia menghilang setelah menghentikan agen iritasi Beberapa leukoplakia dapat berkembang menjadi lesi malignant . tetapi eritroplasia beresiko tinggi sebagai penanda keganasan Leukoplakia secara mikroskopik hiperkeratosis dan displasia Penyebab leukoplakia berhubungan dengan penggunaan tobacco atau trauma berulang.LESI PRAKANKER Leukoplakia premalignant lession.
also have been tried. The side effects were minimal. pengobatan masih tidak jelas. but leukoplakia recurred in 50% of patients after discontinuation of the medication .Lesi mukosa putih ataupun merah membutuhkan biopsi Lesi leukoplakia benigna dan tidak menghilang setelah menghentikan tobako. laser excision. Nonsurgical approaches. Surgical excision. such as topical vitamin A therapy. and similar techniques have all been used with some degree of success. with complete response rates in the 10% to 27% range and partial response rates in 54% to 90% of patients.
and the protracted nature of the treatment course. the patient's physical condition and social and economic situation. Newer techniques brachytherapy and intensity-modulated radiation therapy (IMRT) more focused targeting and reduced complications . Treatment options must be determined by numerous factors. xerostomia. a curative dosage of radiation therapy requires at least 6 weeks of treatment. including the location. When considering oral cavity cancers. Unlike surgery. the highest rate of complications related to external beam radiation occurs in patients with floor-of-mouth cancer. and this can affect the treatment choice. osteoradionecrosis of the mandible developed. but significant disadvantages of radiation therapy are diminution of taste. historically.RADIATION THERAPY Radiation therapy and surgery have equal success in controlling T1 lesions of the oral cavity. Radiation therapy tends to provide a better functional result with superior speech and swallowing. in one fourth or more of these patients. and the experience of those delivering the care.
CHEMOTHERAPY Although the combination of radiation therapy and surgery provides a better chance for cure for stage III and IV disease than does either modality alone. substantial evidence suggests that the addition of concomitant chemotherapy to postoperative radiation therapy improves locoregional control and survival in these patients .
The exophytic lesions may have a relatively benign appearance and may not penetrate into the soft tissues of the cheek until they are relatively large. and skin Because no natural barriers to tumor penetration exist in the cheek. bone.BUCCAL CARCINOMA uncommon cancer Buccal carcinomas occur most commonly in 70-year-old men and are found in a region of cheek leukoplakia. . The ulcerative lesions. however. cure rates are not as good as one might expect in a region so easily inspected. penetrate early and make cure more difficult because of their involvement of adjacent muscle.
large series comparing treatment modalities cannot be found. marginal or rim mandibulectomy or partial maxillectomy or both may be necessary for adequate margins Surgery plus radiation therapy is the treatment of choice for stage III and IV disease. neck dissection. parotidectomy. Because T1 lesions are rare. and depending on the extent of the lesions. respectively. Three-year survival rates for T1 and T2 lesions are approximately 80% and 60%. As with most oral cavity neoplasms. . pectoralis major) flaps or with an osteomyocutaneous free flap if bone is needed. although resection and coverage of the area with a split-thickness skin graft may be more convenient and expedient. T1 lesions can be treated either with surgery or radiation therapy. The extent of resection of these larger lesions is variable. but may include resection of the maxilla or mandible. Reconstruction is with free (radial forearm) or regional myocutaneous (temporalis. or a combination of these.
Only those patients with T4 lesions begin to approach an incidence of nodal metastases (25%) for which prophylactic neck irradiation would be considered. it is unnecessary to be concerned with prophylactic neck therapy. Because nodal metastases are retropharyngeal. Although distant metastases are rare with squamous cell carcinoma of the hard palate. an incidence of 12% has been found in patients with salivary gland tumors .HARD PALATUM CARCINOMA Primary malignancies of the hard palate are uncommon with a relatively equal incidence of squamous cell carcinoma and salivary gland malignancies.
for those of both salivary gland and squamous etiology. the treatment of choice is a combination of surgery and radiation therapy Partial or total maxillectomy is often required. requiring preoperative evaluation by a prosthodontist . and the traditional reconstruction has been with a prosthetic obturator. For the larger T3 and T4 lesions (the 5-year survival rate decreases from 85% for a T1 lesion to 30% for a T4 lesion).Radiation therapy has been reported to be as effective as surgery in treating T1 and T2 lesions. It is probably true. that T1 lesions are most easily treated by excision. however.
with postoperative radiation therapy being reserved for patients with a suspected high rate of local or neck failure.ORAL TONGUE In deciding on treatment modalities for oral tongue cancer. Because of the high complication rate associated with curative doses suggested a policy of initial surgery. and T3-4 lesions do best with combination therapy. . Radiation treatment alone achieves control rates of 86% for T1 and 75% for T2 lesions. T1-2 lesions can be treated by surgery or radiation therapy. the same factors are applicable as for most other head and neck sites.
with expected 2-year disease-free survival rates of 80% and 70%. for patients with stage III and IV disease . with most occurring in the posterior third of the dental arch. Treatment is primarily surgical.ALVEOLUS CARCINOMA Alveolus carcinoma is a relatively rare oral cavity cancer. Stage I and II disease can be treated with surgery alone. 80% are of the lower jaw. radiation therapy is required for the N0 neck. respectively. respectively. but the addition of radiation therapy is important when bony invasion. or perineural invasion is present. the expected 2-year survival rates are 60% and 50%. nodal metastases. When combined therapy is used. and a MRND with radiation therapy is indicated for positive nodal disease. For stage III and IV disease.
these require combination therapy. In a recent retrospective study involving 227 patients. which frequently involves composite resection and complex reconstruction. Cancers of the floor of the mouth are undertreated and tend to reflect a poor stage-for-stage prognosis.FLOOR OF MOUTH One of the problems of using radiation therapy as curative treatment for oral cavity tumors is the proximity of the mandibular arch. Treatment failures occurred at the primary site more than twice as often as did recurrence in the neck . Stage III and IV lesions had disease-specific survival rates of 44% and 47% . stage I and II floor-of-mouth cancers had a 5-year disease-specific survival rate of 72% and 63% Elective neck dissection is typically recommended for T2 and larger or more-aggressive T1 lesions.
E. Greater palatine vessels and nerves Sphenopalatine nerve Palatine nerves and nasopalatine arteries Anterior and posterior superior alveolar nerves Lesser palatine nerve .1. The incisive foramina house the A. C. B. D.
fibrous histiocytoma e. erythroplakia .2. Granular cell myoblastoma c. A benign oral cavity lession sometimes mistaken pathologically for squamous cell carcinoma is a. Squamous papilloma b. leukoplakia d.
Floor of mouth b. Of oral cavity cancers treated primarily with radiotherapy for cure. buccal mucosa d. Tongue c. the site treated with the highest complication rate is the a. Retromolar trigone .3. Anterior tonsillar pillar e.
Due to lack of natural barriers in the cheek. Greater than 6 mm e. Less than or equal to 15 mm .4. between 10 and 12 mm d. Less than 10 mm b. with the following thickness have a batter prognosis a. buccal carcinomas. Less than 6 mm c.
hard palate d. Buccal mucosa .5. Anterior tonsillar pillar c. Floor of mouth b. Primary malignancies of which oral cavity site are equally distributed between salivary gland and squamous cell carcinoma a. Tongue e.
Anterior maxillary segment b. Alveolus carcinomas are most commonly located in the a. Posterior alveolus . Posterior third of the mandible c. anterior mandibular arch d.6. Body of mandible e.
5 cm c. tumor stuck to periosteum d. Assosiated dental infection . Lesions greater than 1. Concern for potential nodal metastase associated with alveolus carcinoma increases when which of the following is present? a. Bony invasion and/or perineural invasion b.7. Involvement of tooth sockets e.
The deep lymphatic plexus of the floor of mouth drains to the a. Ipsilateral and contralateral nodes b. Contralateral nodes only c. Submental nodes only .8. ipsilateral nodes only d. Submental and contralateral nodes e.
Tongue flap e. Split-thickness skin graft c. Full-thickness skin graft b. The most common surgical reconstructive technique for the resurfacing of oral cavity defects after oncologic resection is a. radial forearm free flap d. Myocutaneous flap .9.
A satisfactory base for denture placement e. Possible bone necrosis c. Maintenance of mandibular continuity b. possible pathologic fracture d.10. Rim mandibulectomy may be assosiated with all but which of the following? a. Malignance of a normal cosmetic appearance .
This action might not be possible to undo. Are you sure you want to continue?
We've moved you to where you read on your other device.
Get the full title to continue listening from where you left off, or restart the preview.