1/7. Possibilities of preventing osteoradionecrosis during complex therapy of tumors of the oral cavity.In recent years, there has been a dramatic increase in the number of tumors of the head and neck. Their successful treatment is one of the greatest challenges for physicians dealing with oncotherapy. An organic part of the complex therapy is preoperative or postoperative irradiation. Application of this is accompanied by a lower risk of recurrences, and by a higher proportion of cured patients. Unfortunately, irradiation also has a disadvantage: the development of osteoradionecrosis, a special form of osteomyelitis, in some patients (mainly in those cases where irradiation occurs after bone resection or after partial removal of the periosteum). Once the clinical picture of this irradiation complication has developed, its treatment is very difficult. A significant result or complete freedom from complaints can be attained only rarely. attention must therefore be focussed primarily on prevention, and the oral surgeon, the oncoradiologist and the patient too can all do much to help prevent the occurrence of osteoradionecrosis. Through coupling of an up-to-date, functional surgical attitude with knowledge relating to modern radiology and radiation physics, the way may be opened to forestall this complication that is so difficult to cure.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/7. Malignant fibrous histiocytoma of the head and neck after radiation for squamous cell carcinoma.A 60-year-old man presented with malignant fibrous histiocytoma of the oropharynx. The mass extended into the nasopharynx and larynx and caused severe upper airway obstruction that required emergency tracheotomy. Ten years earlier, he had undergone a right partial glossectomy and segmental mandibulectomy for squamous cell carcinoma of the right tongue base,followed by 50 Gy of radiation delivered over 33 sessions. The tumor was so aggressive that changes in its volume were visually distinguishable during physical examination over a 2-week hospital stay. Histologic evaluation revealed 7 mitotic figures per high-power field. Although radiation-induced malignant fibrous histiocytoma is rare in the head and neck, the recent medical literature indicates that its incidence is rising. This rise has been attributed to the increased effectiveness of head and neck cancer therapy, which results in prolonging patients' survival and, hence, their risk of subsequent disease. Because malignant fibrous histiocytoma is a late complication of radiation therapy, appearing on average 10 years following treatment, it is important that physicians who treat head and neck cancer monitor these patients over the long term and remain alert for its appearance, even despite the apparent "cure" of their original neoplasm.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/7. Oral presentation of Kaposi's sarcoma in a patient without severe immunodeficiency.Primary oral Kaposi's sarcoma of the "traditional type" (non-African, non-acquired immunodeficiency syndrome, nonimmunosuppressed) is a rare disorder. Presentation of this disorder at this site has not been well documented in the surgical pathology literature. This report describes a primary oral Kaposi's sarcoma in an older man without evidence of the acquired immunodeficiency syndrome or overt immunosuppression; this sarcoma recurred three times before a correct diagnosis was made. The case illustrates the importance of including Kaposi's sarcoma in the differential diagnosis. The lesions can easily be confused with pyogenic granuloma if the physician is unaware that primary Kaposi's sarcoma can occur at this site.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/7. Oral diseases in older adults.In the case presented, a 65-year-old man with multiple dental, medical, and social problems benefited from interdisciplinary assessment and treatment. Despite his poor oral-health status and oral-health behaviors upon admission, patient education and dental therapy resulted in improved daily oral hygiene, elimination of oral diseases, and improved oral function. The overall quality of life of any individual, particularly an older one, can be enhanced through oral-disease prevention, health promotion, and, when indicated, dental therapy. This patient was treated in a hospital environment with a well-established team approach to geriatric care. However, regardless of the care setting, the physician can play a key role in improving the oral health status and quality of life of older adults by including an oral screening examination as part of the periodic comprehensive geriatric assessment, recognizing oral pathology, requesting dental consultations and encouraging appropriate dental service utilization.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/7. neurofibroma of the palatal mucosa. A case report.Neurofibromas have not been reported in the periodontal literature. In this case report, a 27-year-old female presented with a complaint of a lump in the maxillary left palatal tissue; periodontal evaluation revealed a mass 15 x 8 x 4 mm on the palatal mucosa. After removal, the region healed without recurrence. The patient was referred to her physician for a physical, and no evidence of neurofibromatosis was found elsewhere, suggesting that this case represented an example of an isolated oral neurofibroma lesion.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/7. Malignant lymphomas of the oral soft tissues.Two cases have been presented in which a malignant lymphocytic tumor was found in the oral soft tissues. The first was a "histiocytic lymphoma" that appeared as a rapidly growing, ulcerative lesion. This tumor was the initial presentation of disease and may be considered a primary lesion. The second was a "poorly differentiated lymphocytic lymphoma" which formed a mass in the mental area. In that case, the tumor was associated with widespread disease. Both of these lesions had previously been diagnosed by physicians as inflammatory processes.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/7. rehabilitation of a patient with complete mandibulectomy and partial glossectomy.Following a number of radiologic and surgical procedures for the treatment of oral cancer, a patient with severe facial disfigurement and alteration of the vocal tract acquired acceptable speech. Consultation among referring physicians and speech pathologists can aid such a patient by facilitating the rehabilitative process through improvement of communicative skills.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |