Tumours of the oral cavity

2021 ◽  
pp. 859-866
Author(s):  
Jonathan A. Dunne ◽  
Paolo L. Matteucci
Keyword(s):  
Neck Dissection ◽  
External Beam Radiotherapy ◽  
Radical Neck Dissection ◽  
Free Flaps ◽  
Nodal Metastasis ◽  
High Rate ◽  
Adjuvant Chemoradiotherapy ◽  
Postoperative Rehabilitation ◽  
Supraomohyoid Neck Dissection ◽  
Common Malignancy

Oral tumours are a common malignancy, with smoking and alcohol the principal aetiological factors. Squamous cell carcinoma is the commonest pathology, most frequently affecting the anterior tongue and floor of the mouth. Surgery is the mainstay of T1/T2 tumour management, and tracheostomy may be required. Sentinel node biopsy is an effective staging procedure; however, there is a high rate of occult nodal metastasis which may warrant elective supraomohyoid neck dissection. Macroscopic nodal disease requires modified radical neck dissection, preferably with adjuvant chemoradiotherapy. For unresectable tumours, radical external beam radiotherapy with cisplatin should be given. Reconstruction of soft tissue involves a range of skin grafts and local, regional, and free flaps, while bony reconstruction includes obturators and non-vascularized and vascularized bone grafts. Postoperative rehabilitation aims to restore speech, mastication, swallow, and dentition. Three-year survival is greater than 90% for stage I/II disease, with excellent functional outcomes.

scholarly journals Bilateral Karapandzic flap: a work horse for carcinoma of lower lip

2020 ◽  
Vol 6 (2) ◽  
pp. 428
Author(s):  
Mada Lakshmi Narayana ◽  
Pramod D. ◽  
Lavanya T. ◽  
Vivek Viswambharan ◽  
Urvashi Gaur
Keyword(s):  
Neck Dissection ◽  
Radical Neck Dissection ◽  
Cervical Lymphadenopathy ◽  
Lower Lip ◽  
Contrast Enhanced ◽  
The Face ◽  
Supraomohyoid Neck Dissection ◽  
Malignant Lesions ◽  
Enhanced Computed Tomography

<p class="abstract">The lips are major aesthetic components of the face, which are also necessary for facial expression, speech, and eating. In oncological resections, the main goal in lip reconstruction is achieving oral competence than speech and facial expressions. Malignant lesions involving lip warrant a wide excision to ensure a disease-free margin, which usually results in large defects. Defects up to 1/3rd of lips are closed primarily. Defects measuring 1/3rd to 2/3rd of the lower lip may be closed with Karapandzic, Abbe or Estlander flaps. A 45-year-old male presented with an exophytic lesion in the lower lip involving the facial skin with bilateral level 1b cervical lymphadenopathy. Contrast-enhanced computed tomography scan showed heterogeneous irregular lesion over the lower lip with bilateral enlarged necrotic level 1b cervical lymphadenopathy. Biopsy from the lesion was suggestive of moderately differentiated squamous cell carcinoma. Wide local excision with left modified radical neck dissection and right supraomohyoid neck dissection was done. The central lower lip defect was reconstructed with bilateral Karapandzic flap. The postoperative period was uneventful, although the patient had microstomia. The patient was advised adjuvant radiotherapy based on histopathology and was in regular follow up.</p>

VENOUS DRAINAGE OF FREE FLAPS FOLLOWING RADICAL NECK DISSECTION

1991 ◽  
Vol 61 (12) ◽  
pp. 903-908 ◽  
Author(s):  
Alan P. Meagher ◽  
Brian F. Sheridan ◽  
Michael J. Jensen ◽  
Rosemary Swift ◽  
Bruce D. Doust ◽  
...  
Keyword(s):  
Neck Dissection ◽  
Radical Neck Dissection ◽  
Free Flaps ◽  
Venous Drainage

Treatment results on advanced neck metastasis (N3) from head and neck squamous carcinoma

2005 ◽  
Vol 132 (6) ◽  
pp. 862-868 ◽  
Author(s):  
André l. Carvalho ◽  
Luiz P. Kowalski ◽  
Ivan M. G. Agra ◽  
Everton Pontes ◽  
Olimpio D. Campos ◽  
...  
Keyword(s):  
Head And Neck ◽  
Neck Dissection ◽  
Distant Metastasis ◽  
Radical Neck Dissection ◽  
Squamous Carcinoma ◽  
High Rate ◽  
Long Term Results ◽  
Neck Metastasis ◽  
Neck Disease ◽  
Radiotherapy Alone

OBJECTIVE: To analyze the long-term results of patients with N3 neck metastasis from squamous carcinoma of the head and neck. STUDY DESIGN: This study is based on the analysis of a retrospective cohort of 224 previously untreated patients with squamous cell carcinoma of the head and neck and lymph node metastasis sized greater than 6 cm (N3) who were evaluated from 1981 to 1996. RESULTS: Fifty-four patients (24.1%) underwent neck dissection, 137 underwent radiotherapy alone (61.2%), and 33 received only supportive care (14.7%). Control of the neck metastasis was achieved in 46 cases among the treated ones (24.1%), varying from 51.9% for the patients who underwent surgery to 13.1% for radiotherapy alone ( P >0.001). Exclusive distant metastasis occurred in 37.0% of the cases who had control of the neck disease. The 3-year overall survival rates were 17.9% for patients who underwent surgery and 7.0% for radiotherapy alone ( P = 0.003). The multivariate analysis showed as independent predictive factors the treatment approach ( P >0.001) and tumor site ( P = 0.016). CONCLUSIONS: This study confirms the poor prognosis of patients with N3 neck disease, mainly when treated by radiotherapy alone. A radical neck dissection associated with adjuvant radiotherapy is indicated whenever feasible. Because of the high rate of distant metastasis, protocols including adjuvant chemotherapy should be investigated.

scholarly journals Effectiveness of Supraomohyoid Neck Dissection in Oral Cancers with N1 Neck

2015 ◽  
Vol 6 (2) ◽  
pp. 73-75
Author(s):  
Shuaib Merchant ◽  
SM Azeem Mohiyuddin ◽  
TN Suresh ◽  
A Sagayaraj ◽  
TR Harshita
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Oral Cavity ◽  
Neck Dissection ◽  
Radical Neck Dissection ◽  
Locally Advanced ◽  
Advanced Malignancy ◽  
Oral Cancers ◽  
Node Metastasis ◽  
Supraomohyoid Neck Dissection

ABSTRACT Aim Lymph node metastasis in squamous carcinoma of oral cavity carries poor prognosis. Majority of patients in our country present with locally advanced malignancy which has high incidence of micrometastasis. A comprehensive neck dissection in patients with N0 and N1 neck is overkill with resultant morbidity. Lymph node metastasis from oral cavity has predictable pattern. Supraomohyoid neck dissection (SOND) is a one stage treatment and staging procedure in patients with locally advanced oral cancer with N0 and N1 neck. Materials and methods We are presenting a series of 117 patients with malignancy of oral cavity with N1 neck who underwent SOND, majority involved buccal mucosa. Among the 117 patients who were clinical N1 cases, 53 (45.3%) were found to have positive nodes on histopathology and 64 (54.7%) were false. Level I lymph node metastasis (77.3%) was seen in majority of the oral cancers. After mean follow-up of 30 months, 71 patients are alive and disease-free, twelve patients had local and six (5.1%) had nodal recurrences. Conclusion Supraomohyoid neck dissection in locally advanced oral malignancies with N1 neck, carries low morbidity and complications and is effective substitute for modified radical neck dissection in suitable cases. Postoperative radiotherapy improves the outcome. How to cite this article Harshita TR, Mohiyuddin SMA, Sagayaraj A, Suresh TN, Merchant S. Effectiveness of Supraomohyoid Neck Dissection in Oral Cancers with N1 Neck. Int J Head Neck Surg 2015;6(2):73-75.

scholarly journals Management of Gingivobuccal Complex Cancer

2008 ◽  
Vol 90 (7) ◽  
pp. 546-553 ◽  
Author(s):  
Sanjeev Misra ◽  
Arun Chaturvedi ◽  
NC Misra
Keyword(s):  
Oral Cavity ◽  
Neck Dissection ◽  
English Language ◽  
Radical Neck Dissection ◽  
Public Health Problem ◽  
Definitive Treatment ◽  
Major Public Health Problem ◽  
Search Terms ◽  
Pubmed Database ◽  
Supraomohyoid Neck Dissection

INTRODUCTION Squamous cell carcinoma of the oral cavity ranks as the 12th most common cancer in the world and the 8th most frequent in males. It accounts for up to one-third of all tobacco-related cancers in India. Cancer of the gingivobuccal complex is especially common in Indians due to their tobacco habits. This review focuses on the management of lower gingivobuccal complex cancers. PATIENTS AND METHODS References for this review were identified by search of Medline and other bibliographic information available in the PubMed database. The search terms carcinoma oral cavity, and cancer oral cavity, buccal mucosa, gingiva, gingivobuccal complex, and alveolus cancer/carcinoma were used. References from relevant articles and abstracts from international conferences were also included. Only articles published in the English language were used. RESULTS Treatment of gingivobuccal complex cancer is primarily surgical. Radical neck dissection, or its modification, is the standard treatment for the node-positive neck. Supraomohyoid neck dissection is the accepted treatment for the node-negative neck. Radiotherapy is usually not the preferred modality of treatment for early gingivobuccal complex cancer. It is used either as postoperative adjuvant treatment or as definitive treatment for advanced cancer with or witihout chemotherapy. Chemotherapy has been used as neo-adjuvant, adjuvant or palliative treatment. Advanced cancers are common and continue to pose a challenge to the multidisciplinary team. CONCLUSIONS Gingivobuccal complex cancer remains a major public health problem despite being highly preventable and easily detectable. Advanced cancers constitute a major proportion of patients presenting for treatment. These patients are difficult to treat and have a poor outcome.

scholarly journals Metastasis Leher Tersembunyi pada Karsinoma Lidah T1-T2

2014 ◽  
Vol 3 (3) ◽  
Author(s):  
Taufiqurrahman Taufiqurrahman ◽  
Camelia Herdini
Keyword(s):  
Neck Dissection ◽  
Primary Treatment ◽  
Nodal Metastasis ◽  
Depth Of Invasion ◽  
Skip Metastasis ◽  
N0 Neck ◽  
Neck Disease ◽  
Elective Treatment ◽  
Supraomohyoid Neck Dissection ◽  
Carcinoma Of Tongue

AbstrakKarsinoma lidah memiliki kecenderungan yang tinggi untuk bermetastasis ke limfonodi leher, bahkan pada stadium awal (T1-T2). Tidak ada metode imaging atau pemeriksaan lain yang dapat mendeteksi metastasis leher tersembunyi. Ketebalan atau kedalaman invasi tumor adalah satu-satunya kriteria prediktor metastasis nodal pada karsinoma lidah dengan nilai cut offberkisar antara 3-9 mm. Diseksi Leher Selektif (DLE) level I-III "Diseksi Leher Supraomohioid" (DLSOH) telah direkomendasikan sebagai terapi utama karsinoma lidah stadium awal dengan klinis Node negatif (N0). Hanya pada sebagian kecil kasus yang mengalami metastasis ke level IV yang dikenal dengan “skip metastasis”,extended supraomohyoid neck dissectionlevelI-IV direkomendasikan oleh beberapa penulis. Diseksi leher bilateral harus dilakukan bila telah melibatkan struktur midline lidah.Kata kunci: karsinoma lidah, metastasis leher tersembunyi, diseksi leher supraomohioid AbstractCarcinoma of tongue has a high propensity for nodal metastasis in the neck, even in early stages (T1–T2). There is no method of imaging or other examination that will detect occult nodal metastasis. Tumor thickness or depth of invasion is the only size criterion predictor of nodal metastasis in carcinoma of tongue, the critical cut off values ranged from 3 to 9 mm. Selective dissection of levels I–III “supraomohyoid neck dissection” has been recommended as a primary treatment of neck disease in early carcinoma of tongue with clinically N0 neck. Most of the relatively small number of isolated metastasis to level IV are from primary tumours of the tongue, which are known as “skip metastasis”. Thus an extended supraomohyoid neck dissection of levels I–IV is recommended by some authors for elective treatment of the neck in carcinoma of tongue. Bilateral neck dissection should be performed in elective treatment of tumours involving midline structure.Keywords : carcinoma of tongue, occult nodal metastasis, supraomohyoid neck dissection

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