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At least 325 records · Page 18Linked to original sources

Use of intraoral prostheses in external beam radiation of oral and perioral cancer.

An intraoral prosthesis can be used to position and immobilize tissues in beam-directed radiation therapy for cancer. The prosthesis stabilizes oral structures within the treatment field to permit improve control of field size and thus spare tissues that do not require treatment. The use of an oral prosthesis diminishes both early and late complications of radiation treatment. The prostheses can be used to advantage in conjunction with free-hand and precision methods for the orientation of patients.

Aged↗

Associations between selected demographic parameters and dental status: potential implications for orodental rehabilitation.

PURPOSE: This pilot study evaluated potential relationships between dental status and various sociodemographic variables in the age group segment of the United States population at greatest risk for the disruption of dental function due to treatment of an oral cavity cancer. METHODS: The Dental Health Supplement of the 1989 National Health Interview Survey was used to evaluate the self-reported status of natural dentition and prior dental rehabilitation among the population of persons 45 years or older. RESULTS: Sociodemographic variables, which showed a significant association with status of natural dentition, were level of income and occupation at lower income levels (p < 0.05). Increased levels of prior dental rehabilitation were significantly associated with lower age, female gender, increased level of income, and occupation (p < 0.05). Occupations that required social interaction had the highest levels of both status of natural dentition and prior dental rehabilitation (p < 0.05). CONCLUSIONS: Overall dental status after treatment of oral cancer may be related to the occupational status of many persons. Sociodemographic factors that influence the dental rehabilitation needs of individual patients after treatment of an oral cancer should be considered in policy decisions affecting accessibility of dental rehabilitative care. A follow-up, survey study that would further define the identified relationships between a person's demographic status and dental rehabilitation needs is recommended.

Age Factors↗

Musculocutaneous flaps in head and neck reconstruction.

The development of the new myocutaneous flaps in recent years has ushered in an era of early reconstructions with one-stage repairs. The availability and reliability of these flaps make them appealing for use at a variety of sites. The experience gained from the use of these new flaps has confirmed their safety and versatility even within radiated fields. Since these flaps permit reconstruction in one stage, patients face less disability and their hospital stays are shortened.

Head and Neck Neoplasms↗

Secondary chemoprevention of upper aerodigestive tract tumors.

Patients with successfully treated upper aerodigestive tract (UADT) tumors commonly develop second primary tumors (SPTs). These tumors occur more often than chance would predict, arise in both the upper or lower aerodigestive tracts, are frequently preceded by leukoplakia, and are a major cause of treatment-related failure. Measures to control SPTs include primary prevention with tobacco and alcohol abstinence, surveillance endoscopy, and secondary chemoprevention. Chemoprevention is the administration of natural or synthetic substances to suppress or reverse the malignant process. Secondary chemoprevention of the UADT is the suppression or reversal of leukoplakia and/or SPTs. Classic antioxidant micronutrients such as retinoids, carotenoids, and certain other agents have been effective in nonrandomized and randomized clinical trials, but treatment is uncertain and recurrences common. These facts, coupled with recent harmful effects of beta-carotene in two clinical trials, stress the need for additional basic science, translational, and clinical research. Chemoprevention is a promising new technology, but is not currently standard therapy for the secondary prevention of UADT tumors.

Antioxidants↗

Radiotherapy and hyperbaric oxygen in head and neck cancer. Interim report of second clinical trial.

A controlled clinical trial is in progress to assess the value of hyperbaric oxygen and radiotherapy in the management of head and neck cancer. An established dose-fractionation schedule in hyperbaric oxygen is being compared with a widely used conventional schedule in air. Survival and local recurrence-free rates are significantly higher in the oxygen group, and the effects on normal tissue are similar in both groups. These findings suggest a genuine therapeutic advantage. There was a distinct improvement in the results of treating advanced laryngeal carcinoma, where there was a high survival rate, without resort to laryngectomy.

Clinical Trials as Topic↗

Use of computed tomography in the assessment of mandibular invasion in carcinoma of the retromolar trigone.

Carcinomas originating in the retromolar trigone (RMT) are uncommon and characterized by early spread. Determination of mandibular invasion is significant for planning therapy and determining prognosis. For oral cavity cancers in general, CT is reasonably accurate in assessing bone invasion. However, there is a paucity of information specifically addressing the value of CT in the RMT. In this study, the records of patients with biopsy-proven RMT carcinomas treated between 1984 and 1998 were reviewed with attention to preoperative CT scans and histopathologic findings during surgery. Half of the patients who were treated with primary resection had mandibular invasion. Bone invasion was not identified radiographically in 27% of patients with preoperative CT scans. The sensitivity of CT for bone involvement in RMT cancers was 50%, with a negative predictive value of 61.1%. The positive predictive value was 91.1%. These findings suggest that CT is a useful, but potentially inaccurate, predictor of bone invasion in the RMT.

Carcinoma, Squamous Cell↗

Therapeutic arterial embolisation of vascular lesions in the maxillofacial region.

The technique of therapeutic arterial embolisation involves the introduction of a thrombus-inducing material into the lumen of a blood vessel to occlude the vessel and reduce the blood supply to a lesion or to a specific part of the body. It is particularly useful in the maxillofacial region in the management of vascular lesions where marked diminution in blood flow can be achieved. This paper reviews the procedure and the materials for embolisation, and describes four patients for whom it was of considerable assistance.

Adolescent↗

The role of angiogenesis in the spread of oral squamous cell carcinoma.

Microvessels were counted in 41 primary oral squamous cell carcinomas using JC70 antibody to PECAM (CD31). The counts were compared with clinical and pathological indicators of tumour behaviour including lymph node status, tumour stage, type of histological differentiation, size and velocity of tumour growth. Tumour microvessel counts correlated with lymph node metastasis (p < 0.001). This association was independent of tumour size, velocity and type of histological differentiation and when all the variables were analysed by multivariate analysis only vascular count showed a significant association with lymph node metastasis.

Carcinoma, Squamous Cell↗

Mandibular invasion by squamous cell carcinoma: a computed tomographic and histological study.

Our knowledge of the entry and spread of oral cell carcinoma (SCC) into the mandible is increasing, making an impact on surgical planning. Fourteen resection specimens of mandibular bone and adjacent SCC were radiographically (CT) and histologically investigated. In six cases there was no involvement of mandibular bone; a continuous periosteal layer separated the tumour from bone. The remaining eight specimens showed bony involvement with good correlation between corresponding CT and histological slices in the five edentate cases. The site of entry of the tumour into the bone was usually through the alveolar crest with additional spread through the lingual cortex in tumours that lay lingual to the mandible. Although limited, our data shows that the main site of entry of SCC is through the alveolar crest. It also highlights the usefulness of CT in the identification of bone involvement in edentate cases. This information may assist in the planning of operations to preserve as much bone as is consistent with complete excision of the tumour.

Alveolar Process↗

Oral and maxillofacial tumours in children: a review.

This retrospective review presents our experience of oral and maxillofacial tumours in children. The subjects were 250 children under the age of 15 years (out of a total of 2747 patients with oral and maxillofacial tumours), who were treated after histopathological confirmation of their diagnoses during the 28 years 1965-92. Diagnosis, incidence, and age at presentation were the main outcome measures and the results showed that 232 patients (93%) had benign tumours and 18 (7%) were malignant. The most common benign tumour was haemangioma (n = 69) and the most common malignant tumour sarcoma (n = 14). The most common odontogenic tumour was odontoma (n = 47) and non-odontogenic tumour ossifying fibroma (n = 5). The most common site of soft tissue tumours was the tongue (n = 65) and of bony tumours the mandible (n = 62). About a third of the tumours developed in patients between the ages of 6 and 11 years. Most of the angiomas developed in patients less than 6 years old, and most of the ameloblastomas in those over 12 years of age. Children accounted for 55% of patients with lymphangoma, 41% of those with odontoma, and 22% of those with haemangioma. It is concluded that most of these lesions were probably developmental malformations rather than neoplasms, and that the definition of oral and maxillofacial tumours in children should be reconsidered.

Adolescent↗

The use of the buccal fat pad for reconstruction of oral defects: review of the literature and report of 15 cases.

PURPOSE: Although the buccal fat pad (BFP) was originally used as an alternative method for the closure of small to medium-sized oroantral and oronasal communications, its use has now been extended to use after excision of oral malignancies. This report describes experience with this technique. PATIENTS AND METHODS: The BFP was used as a pedicled graft to reconstruct medium-sized surgical defects of the oral soft and hard tissues in 15 patients suffering from oral malignant tumors. Six of the defects were in the maxilla, 3 in the retromandibular area, and 6 in the cheek and oral commissure. The BFP was left uncovered to epithelialize in 14 patients, and in one it was covered with lyophilized dura. RESULTS: The BFP healed without complications within 3 to 4 weeks in 13 patients, whereas in 2 patients with maxillary defects there was partial loss of the graft, requiring the additional use of an obturator in 1 case and a tongue flap in another to prevent oronasal leakage. Harvesting the graft proved to be extremely easy, and care was only necessary to avoid severing the supporting vascular plexus and the thin capsule covering the BFP. CONCLUSIONS: The findings support the view that the BFP is a useful, easy, and uncomplicated alternative method for the reconstruction of small to medium-sized surgical defects of the oral hard and soft tissues.

Adipose Tissue↗