[Surgical and reconstructive therapy of oral-maxillary neoplasms].
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The authors report the results of radiocinematographic examinations of 98 patients operated on for oral and maxillary neoplasms with analysis of the disturbances of various phases of deglutition in relation to the site and extent of the operation. Leakage into lower respiratory tract is discussed. Extensive operations in the mouth and on the lower and upper jaws were found to cause disturbances of both deglutition phases, and retention of contrast in postoperative tissue defects limitation of the movements of various anatomical structures were the most frequent disturbances of deglutition.
During 1968-1979, 55 cases of epithelial neoplasms originating from the maxillary antrum were diagnosed and treated within the referral area of 1.5 million inhabitants. A majority of the patients were operated upon after pre-operative irradiation therapy (40-50 Gy). No significant difference in survival rate was found between patients operated on by total maxillectomy, including orbital exenteration, and patients subjected to partial maxillectomy. Patients with tumours not completely removed during primary surgery and patients with glandular involvement had a poor prognosis despite additional surgery and radiotherapy. The prognosis for the remaining patients was considerably better, with a 5-year survival rate of 60 per cent.
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Malignant neoplasms of maxillary sinuses are a serious diagnostic and therapeutic challenge, so the objective of a clinician is the planning of a cost-effective strategy promptly leading to proper diagnosis and the onset of treatment. Thus the aim of the paper was the elaboration of diagnostic strategy in maxillary neoplasms. There were analyzed 163 case records of 78 patients with maxillofacial neoplasms. The number and sequence of the conventional radiograms as well as diagnostic imaging methods were registered. There was proposed an algorithm of application of imaging techniques in diagnostics of neoplasms of maxillary antra. It was found that conventional X-rays are still valuable in screening for sinus pathology and as indication of the necessity of performing other imaging examinations. Computed tomography and magnetic resonance are complementary in visualization of pathologic masses and bone tissue destruction.
History of treatment of maxillary malignant neoplasms goes back to the middle of 19th century, when Gensoul and Lizzard performed their first maxillectomy. However the development of maxillar surgery is connected with achivements of Moure, who as the first one characterized and applied innovative skin cut on the face. Author presents the history of other surgical procedures in therapy of maxillary tumors and describes methods which are apply nowaday. Attention is paid to the Polish contributions and accomplishments in diagnostics and treatment of tumors localized in this area. The classification of maxillary tumors from Sebileau dissertation till the newest TNM classification from 2001 is described.
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