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[The role of simultaneous chemotherapy and radiotherapy in the treatment of locally metastasised tumours of the larynx, pharynx and oral cavity].

In The Netherlands each year there are 2300 new patients with a squamous-cell carcinoma of the larynx, pharynx and oral cavity, and of these, one-third has a locally regionally advanced tumour. An operation can then lead to an unacceptable loss of function, whilst radiotherapy alone has no effect on survival. Compared to radiotherapy alone, the combination of radiotherapy and chemotherapy containing cisplatin, when administered simultaneously, produces a higher percentage of patients with loco-regional control and a higher 3-year survival percentage. This improvement in treatment results is accompanied by an increased acute toxicity.

Carcinoma, Squamous Cell↗

[Malignant fibrous histiocytoma].

Malignant fibrous histiocytoma is a neoplasm that can occur both in soft tissue and bone but it is preponderantly found in soft tissue of the extremities. The majority of cases occur in late adult life; and, males are affected more often than females. Most of the patients come to see the doctors because of a mass in various regions and pain. The prognosis is poor, patients usually die from metastasis of the neoplasm to important organ. According to some reports, the neoplasm can occur in oral soft tissue and jaw, thus, dentists should know about important features of the neoplasm in order to be able to diagnose it from other benign oral lesions and can treat correctly.

Histiocytoma, Benign Fibrous↗

Temporal myofascial flap in reconstructive surgery of the oral cavity.

AIM: The temporal myofascial flap is a simple, rapid and reliable surgical method for immediate reconstruction of facial defects: indications in the light of modern anatomical knowledge and personal experience, with the accent on achieving an appropriate access route without damaging the facial nerve. METHODS: Our series covers the period from January 1999 to December 2004, during which time myofascial flaps of temporal muscle were used for immediate reconstruction in 20 surgical oncological cases involving the face and neck. RESULTS: Postoperative progress was regular; no lesions of the facial nerve were observed, nor any cases of flap necrosis, including partial. Epithelialisation could already be observed as early as 15 days postsurgery without skin grafting being employed. CONCLUSIONS: Application of a Medpor prosthesis eliminates the only negative outcome from the aesthetic standpoint, related to harvesting the muscle from the fossa.

Adenocarcinoma↗

[Treatment of 113 oral and maxillofacial hemangiomas with long pulsed turnable 1064 nm Gentle YAG laser].

PURPOSE: To evaluate the clinical therapeutic efficacy on hemangioma of oral maxillofacial regions using pulsed Gentle YAG laser. METHODS: Since April 2005 to August 2005, 113 cases of oral and maxillofacial hemangiomas were treated using pulsed Gentle YAG laser 1064 nm wavelength in our department. Minimal coagulation laser dosage was defined and used to avoid side effects such as thermal skin damage. The laser dosage was 170-240 J/cm2, with 1.5 mm in diameter spot and pulse wide of 30-60 ms. Dynamic cooling device set was used 10-20 times and 10-15 times pre- and post-pulse respectively. 9 of 113 cases had two sessions of treatment, 104 underwent only one session. 96% cases were followed up for 4-6 months. RESULTS: Total response was achieved in 85 cases (75.22%), good response in 28 cases (24.78%), fair response and poor response was 0. Temporary side effects included hyper-pigmentation in 11 cases (9.73%), hypo-pigmentation in 2 cases (1.77%), and they disappeared after 4 to 6 months. 7 cases had scar formation accounting for 6.19%. CONCLUSION: The minimal coagulation dosage pulsed Gentle YAG laser is a good tool to treat hemangioma in oral and maxillofacial regions. It has the advantage of fast efficacy, short term sessions and fewer side effects. It is worthy of wide clinical application.

Face↗

[Incidence and clinical consequences of distant metastases in the area of the jaw/face].

Metastases from primary tumours and distant sites to the maxillofacial region are rare. The establishment of an exact diagnosis is often difficult because of the atypical clinical and roentgenological appearances. Thirty-five cases of distant metastases to oral soft tissues and jaws are presented. The most common primary tumours were renal carcinomas followed by breast cancers. In most cases metastatic lesions lie in the distal segment of the mandible. The possibilities of treatment are very limited.

Cheek↗

Mandibular reconstruction using vascularized bone grafts.

Total oromandibular reconstruction following cancer extirpation remains a significant challenge to the head and neck surgeon. Reconstructive goals must address occlusion, salivary continence, mastication, deglutition, and articulation. In this article, various methods of mandibular reconstruction, with special attention to the most recent advances in vascularized bone and free tissue transfer techniques, are reviewed.

Bone Transplantation↗

[Experience in staging malignant tumors of the orofacial area].

The paper reports the authors experience at the Regina Elena Institute for the Study and Treatment of Tumours in Rome during the period 1987-1989 concerning the setting up of a register for primary malignant tumours of the head and neck. This experience has allowed various parameters to be assessed from the initial diagnosis through the subsequent diagnostic and therapeutic procedures [correction of iter]. The stage of disease was assessed in 134 patients using a TNM system proposed by UICC for tumours located in the oral cavity, oro- and hypo-pharynx and maxillary sinuses. At the end of the period a complete definition was made of some typical aspects of the disease in question: firstly, the high incidence of patients with advanced stages of disease found at the first diagnosis, and secondly, the significant delay in confirming the diagnosis of the tumour in spite of the ease with which the area may be explored. In conclusion, the authors comment on current systems of TNM classification, underlining the need for a more correct interpretation and assessment of findings related to neoplastic orofacial pathologies.

Facial Neoplasms↗

[Radionuclide bone scan using single-photon emission-computed tomography in detecting oral and maxillofacial tumor infiltrating to the jaws].

83 cases (including 53 cases of patients and 30 cases of normal volunteer) of SPECT bone scan had been studied for detecting oral and maxillofacial tumor infiltrating to the jaws. The results was contrasted with X-ray, operation and pathology, and indicated that SPECT bone scan could reveal the early tumor infiltrating to the jaws and accurate extent of tumor lesions, more accurate than X-ray. SPECT provided us more important information about the preservation of the jaw and extent of bone resection.

Carcinoma, Squamous Cell↗