1/6. 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) |
2/6. White sponge nevus of the tongue.To my knowledge, this is the fifth case of white sponge nevus of the tongue to be reported. This lesion is probably much more common than has been reported in the past. The disorder is benign and almost always asymptomatic. The recognition of this disorder is important in that it must be differentiated from other congenital or familial disorders of more widespread clinical significance. It is important for any physician, and especially for dermatologists, to do a thorough examination of the oral mucous membranes as a part of any physical examination.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/6. The reasons for discrepancies in target volume delineation : a SASRO study on head-and-neck and prostate cancers.PURPOSE: To understand the reasons for differences in the delineation of target volumes between physicians. MATERIAL AND methods: 18 Swiss radiooncology centers were invited to delineate volumes for one prostate and one head-and-neck case. In addition, a questionnaire was sent to evaluate the differences in the volume definition (GTV [gross tumor volume], CTV [clinical target volume], PTV [planning target volume]), the various estimated margins, and the nodes at risk. Coherence between drawn and stated margins by centers was calculated. The questionnaire also included a nonspecific series of questions regarding planning methods in each institution. RESULTS: Fairly large differences in the drawn volumes were seen between the centers in both cases and also in the definition of volumes. Correlation between drawn and stated margins was fair in the prostate case and poor in the head-and-neck case. The questionnaire revealed important differences in the planning methods between centers. CONCLUSION: These large differences could be explained by (1) a variable knowledge/interpretation of ICRU definitions, (2) variable interpretations of the potential microscopic extent, (3) difficulties in GTV identification, (4) differences in the concept, and (5) incoherence between theory (i.e., stated margins) and practice (i.e., drawn margins).- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/6. 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) |
5/6. lymphangioma of the tongue.Lymphangiomas are uncommon congenital tumors of the lymphatic system which usually occur in the head and neck; involvement of the tongue is rare. We report the case of a six-year-old Asian girl with a lymphangioma of the tongue. The differential diagnosis and treatment of tongue lymphangioma are also reviewed. It is important for emergency physicians to recognize unusual lesions such as lymphangioma, because early recognition and surgical excision of these tumors are essential for an optimal outcome.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/6. carcinoma of the oral cavity in a young woman.Although tobacco and alcohol abuse are known factors in the genesis of many head and neck cancers, none of the consultants believe that the cause and effect is established in younger patients. No one is willing to make a connection between her carcinoma and her connective tissue disease. With regard to panendoscopy, the consultants would perform a rigid bronchoscopy and an esophagoscopy (Dr. Donald), laryngoscopy and esophagoscopy (Dr. Eibling), and esophagoscopy (Dr. DeSanto). (Editor's note: bronchoscopy and/or esophagoscopy have been considered standard in the evaluation of patients with head and neck malignancies, but the editor believes there is little or no justification for endoscopy in nonsmoking young adults.) There is consensus as to how to treat this woman. The consultants concur that excision followed by radiotherapy offers the best chance for cure. On expert (Dr. Eibling) suggests that postoperative chemotherapy should also be given. radiotherapy or chemotherapy alone are not options that anyone believes in as curative. Cure rate estimates center around 40% to 50% five-year survival (Dr. Donald) or 30% to 50% (Dr. Eibling). One physician believes it is useless to estimate the patient's odds (Dr. DeSanto). When this patient refuses surgery and stops her radiotherapy, one expert suggests waiting until the mucositis resides and proceeding with a resection (Dr. Donald). Another encourages completing the course (Dr. Eibling) and another believes there are no guidelines in such an ad-hoc program (Dr. DeSanto).(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |