Clinical Examination of Oral Cavity and Head and Neck

Author(s):  
Bimal Sinha ◽  
Krishna Koirala

There are three main pairs of major salivary glands in the head and neck, namely the parotid, submandibular, and sublingual salivary glands. In addition to these major glands there are numerous minor salivary glands distributed throughout the oral cavity. These minor salivary glands are situated in the adnexal layer of the oral mucosa. This chapter covers the relevant anatomy, physiology, taking a history, clinical examination, and investigations. It then goes on to discuss xerostomia, Sjögren’s syndrome, diffuse and localized gland swelling, sialolithiasis, ranula, and disorders of the minor salivary glands.


Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 271
Author(s):  
Saverio Capodiferro ◽  
Luisa Limongelli ◽  
Gianfranco Favia

Many systemic (infective, genetic, autoimmune, neoplastic) diseases may involve the oral cavity and, more generally, the soft and hard tissues of the head and neck as primary or secondary localization. Primary onset in the oral cavity of both pediatric and adult diseases usually represents a true challenge for clinicians; their precocious detection is often difficult and requires a wide knowledge but surely results in the early diagnosis and therapy onset with an overall better prognosis and clinical outcomes. In the current paper, as for the topic of the current Special Issue, the authors present an overview on the most frequent clinical manifestations at the oral and maxillo-facial district of systemic disease.


2021 ◽  
Vol 13 ◽  
pp. 175883592098406
Author(s):  
Vanesa Gutiérrez Calderón ◽  
Alexandra Cantero González ◽  
Laura Gálvez Carvajal ◽  
Yolanda Aguilar Lizarralde ◽  
Antonio Rueda Domínguez

Squamous cell carcinoma of oral cavity (OCSCC) accounts for approximately 25% of cases of head and neck squamous cell carcinoma (HNSCC). Tobacco and alcohol consumption are the main risk factors for both cancers. Surgical resection, combined with adjuvant radiotherapy or radiochemotherapy in patients with high risk of relapse, is the key element in management in the initial stages. However, despite the availability of aggressive multidisciplinary treatments, advanced resectable OCSCC carries poor prognosis; only half of the patients are disease-free 5 years after the surgery. Immunotherapy based on the use of immune checkpoint inhibitors has been proven to be effective in a wide variety of tumours, including recurrent and metastatic HNSCC. These positive results resulted in investigations into its effectiveness in earlier stages of the disease with OCSCC emerging as an interesting research model because of the accessible location of the tumours. This article reviews the potential advantages of emerging immunotherapeutic agents [mainly monoclonal antibodies against programmed cell death-1 ( PD-1) immune checkpoint inhibitors] as neoadjuvant treatment for OCSCC at locoregional stages as well as the ongoing clinical trials, challenges in evaluating tumour response, and possible predictive biomarkers of response with highlights regarding the role of oral microbiota as modulators of immune response. The efficacy and safety of anti- PD-1 drugs in these patients have been proven in preliminary trials. If there is a decrease in the relapse rate and an improvement in the overall survival after surgical resection in ongoing trials, preoperative immunotherapy may be established as a treatment option for patients with early stages of the disease.


1985 ◽  
Vol 93 (3) ◽  
pp. 342-346 ◽  
Author(s):  
Melvin Strauss ◽  
A. Bennett Jenson

The association of human papillomavirus with benign and malignant epithelial lesions of the head and neck has been studied by a peroxidase-antiperoxidase technique having immunospecificity against genus-specific structural antigens of the papillomaviruses. More than 360 specimen blocks from 144 patients were evaluated. There was evidence of human papillomavirus antigen in three out of eight patients with childhood-onset laryngeal papillomas (37.5%) and in four out of eight patients with adult-onset papillomas (50%). A patient with an unusual flat, wartlike lesion appearing as an oral cavity leukoplakia had detectable papillomavirus antigen in it. None of the 13 cases of inverting papilloma or any of the malignant lesions studied showed evidence for the presence of papillomavirus antigen. There is currently only suggestive evidence for the oncogenic potential of human papillomavirus in the head and neck.


2021 ◽  
pp. 50-51
Author(s):  
Ayesha Agarwal ◽  
Trishan Paul ◽  
Rudra Kanta Gogoi ◽  
Rheetwik Baruah ◽  
Chiranjeev Baruah

In India, head and neck cancers (HNCA) account for 14.3% cancers at all sites. In North-eastern India, there is a high prevalence of HNCA which can be associated with pervasive habit of using tobacco, lime and betel. The alarmingly high prevalence of cancers of head and neck in this part of India has prompted us to take up this study. Ahospital-based study on prevalence of cancer in various head and neck regions like oropharynx, oral cavity, pharynx, larynx, salivary glands and nasal cavity was conducted in Department of Radiation Oncology, Assam Medical College and Hospital from June 2020 to May 2021.The prevalence is found to be signicantly high at 57.59%, affecting males more than females in the age group of 50-59 years. HNCA of hypopharynx and oral cavity constituted a major burden of total body cancer. This study hopes to quantify and analyse the HNCAspectrum and should help as a starting point for a much needed population based study in this region. Acomprehensive effort is required to identify the cause of such high prevalence of HNCAin this region of India, generate awareness and treatment options suited to meet this challenge.


2019 ◽  
Vol 15 (2) ◽  
pp. 50-55
Author(s):  
Наталья Нуриева ◽  
Natal'ya Nurieva ◽  
Александр Гузь ◽  
Aleksandr Guz ◽  
Александр Захаров ◽  
...  

Subject: malignant neoplasms of the oral cavity, primary detectability, appeal to specialists, terms of treatment before hospitalization. Objective: based on a five-year analysis of the medical records of patients with a verified diagnosis of malignant neoplasm of the oral cavity, to identify significant criteria for primary diagnosis, doctors of the first contact, including non-cancer profile. Methodology. Malignant neoplasms occupy one of the leading places among all medical and social problems. This is due to a number of reasons, among which are particularly high rates of morbidity and mortality, late treatment of patients and frequent disability. the Purpose of early detection of malignant tumors of the oral cavity is to increase the effectiveness and radicality of treatment, increase the possibility of dental rehabilitation, reduction of disability. To write this article, we conducted a five-year analysis of the primary detection of malignant tumors of the oral cavity in 76 patients hospitalized for treatment in the head and neck Department of the Chelyabinsk district Oncology center. All patients with histologically confirmed diagnosis. Everyone needs specialized anti-tumor treatment. In addition to standard diagnostic procedures, all patients were surveyed on the issues of primary complaints and appeals to medical specialists. Results. On the example of the received questionnaires as well as the standard medical examinations conducted upon admission to the head and neck Department, the trends of the primary referral of patients to primary contact doctors, the terms of treatment before referral to a specialized oncological institution, the stage of the process and the presence of metastasis of the primary focus during treatment, the presence of aggravating factors are analyzed. Conclusions. The results for the five-year period in patients with primary malignant neoplasm of the oral cavity were evaluated, practical recommendations on clinically significant symptoms of malignant tumors of the oral cavity, orientation on the timing of observation were given.


2003 ◽  
Vol 60 (6) ◽  
pp. 753-756 ◽  
Author(s):  
Dragana Dakovic ◽  
Besir Ljuskovic ◽  
Ivan Mileusnic ◽  
Vesna Tepsic

This report presents a case of a psychiatric patient with scurvy. Upon the clinical examination of the oral cavity, dry and pale lips were noted. Gingiva was highly edematous, soft, purple blue with ulcerated margins. Bleeding was noted upon slightest provocation. Teeth were also affected by the vitamin C deficiency with multiple caries. The patient was asthenic and adynamic. Petechial bleeding and hematomas were present on the skin of extremities. Therapy consisted of rehydration and vitamin C compensation - 2 g daily i.v. during 10 days period, and 1.5 g daily orally during the following 2 months. The patient maintained only partial plaque control, and complete recovery of the oral cavity was not established because the patient didn?t comply. Concerning that scurvy is a rare disease nowadays, it is very important to recognize its clinical signs, and to establish a valid and prompt diagnosis, because, when untreated, scurvy can have severe consequences on the entire organism.


2020 ◽  
pp. 3-5
Author(s):  
Ayesha Goel ◽  
Ritu Nigam

Myiasis in head and neck region is a rare occurrence and is usually found in tropical countries like India. Poor hygiene, unsanitary living conditions, mental retardation, neglected wounds, diabetes mellitus and old age along with a warm and humid climate lay down a conducive environment for the larva of dipterous fly to infest humans. Maggots due to their tissue destructive properties can affect many regions in otolaryngorhinology like nasal cavity, ears, oral cavity, tracheostomy site ostoma, PNS, the skin and ulcerative lesions of head and neck. The burden of the disease lies in the fact that the complications range from minor tissue destruction, perforation of either the tympanic membrane, palate or septum, vertigo, angioedema to severe neurological manifestations, intracranial extension or rarely even death. Objective: To assess the commonly affected age group and gender infested by myiasis, it’s seasonal trend, socioeconomic status of the affected patients and the relationship of myiasis infestation with various predisposing factors. Methodology: Retrograde study was conducted on 95 patients of department of otorhinolaryngology. The study was done from January 2015 to October 2018 by collecting data of 3 years 10 months time interval and results tabulated. Ethical clearance was sort and patients consent obtained. Result: The most commonly affected age group was found to be elderly, in the 7th decade of life (56.84%). Females were more commonly affected than males consisting of 55 out of 95 cases (57.89%), with a male female ratio of 1:1.4. Majority of cases presented in the months of October-January, with a peak in November (32/95). Nasal myiasis was found to be more common (69 cases) in comparison to aural and oral cavity myiasis. The most common predisposing factor was found to be Atrophic Rhinitis in 66.7% cases. Conclusion : With awareness and improved personal hygiene a devastating disease like myiasis is easily preventable and curable.


1994 ◽  
Vol 111 (3P1) ◽  
pp. 236-242 ◽  
Author(s):  
Michael G. Stewart ◽  
Newton O. Duncan ◽  
Daniel J. Franklin ◽  
Ellen M. Friedman ◽  
Marcelle Sulek

Erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis are related disorders of skin and mucous membranes, which are typically associated with antecedent medication use or infection. We review 108 cases of erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis from Texas Children's Hospital, Houston, Texas, from 1981 to 1991, and illustrate the characteristic skin and mucosal lesions. In addition, we describe in detail two unusual cases requiring intensive airway management. Head and neck manifestations were present in 4 of 79 patients (5%) with erythema multiforme and 26 of 28 patients (93%) with Stevens-Johnson syndrome. In Stevens-Johnson syndrome, mucosal involvement of the lip (93%), conjunctiva (82%), oral cavity (79%), and nose (36%) were most common. Antecedent medication use was identified in 59% of erythema multiforme patients and 68% of Stevens-Johnson syndrome patients. We note a striking increase in the number of cases in our series caused by cephalosporins. Fifty percent of Stevens-Johnson syndrome patients required supplemental hydration or alimentation because of the severity of the oral cavity involvement. The head and neck mucosal manifestations largely respond to local care, and the routine use of prophylactic antibiotics or systemic steroids is not recommended.


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