Perioperative management of maxillofacial tumor and reconstruction patients.

Patients who undergo maxillofacial tumor surgery and reconstruction present many perioperative management challenges. This patient population commonly presents with significant medical comorbidities in addition to the site-specific challenges of these tumors and the complexity of the reconstructive surgeries. This article combines a review of the relevant literature and the experience of a busy regional maxillofacial tumor and reconstruction referral center to provide a concise reference for management of patients.

Surgical management of cutaneous melanoma of the head and neck.

Surgical management of cutaneous malignant melanoma of the head and neck requires careful assessment of the primary lesion, use of appropriate biopsy and excision technique, and assessment of the regional lymphatics in all but the thinnest of lesions. Sustained disease-free survival can be achieved with appropriate initial intervention and serial follow-up. The major significant differences between current and past management are the advent and acceptance (or not) of sentinel node biopsy technique for intermediate thickness lesions without evidence of lymphadenopathy and an improved, validated, staging system.

Mandibulotomy fixation: a laboratory analysis.

Purpose: Mandibulotomy is an access osteotomy technique associated with significant complications. Critical evaluation of available fixation systems is required to aid in the selection of the most stable fixation method. This study was designed to provide data on the stability of traditionally used plating configurations and a low-profile 2.

Oral and oral pharyngeal cancer: an update on incidence and epidemiology, identification, advances in treatment, and outcomes.

Dental health care providers offer a primary means by which improvements in outcome in oral and oral pharyngeal cancer can be realized. Early detection of mucosal abnormalities (e.g.

Intraoral minor salivary gland neoplasm: a single institution experience of 80 cases.

From March 1991 to February 2001, 80 cases of minor salivary gland tumours were diagnosed in the Department of Oral and Maxillofacial Surgery at the University of Maryland at Baltimore (Baltimore, MD, USA). Data extracted from a retrospective chart review included age, sex, symptoms, site, histological diagnosis. treatment and outcome.

Ameloblastoma in children.

Purpose: The purpose of this report was 1) to report the experience of the University of Maryland, Department of Oral and Maxillofacial Surgery (OMS Department) in the treatment of ameloblastoma in children and 2) to review the world literature on the treatment of ameloblastoma in children from 1970 to 2001.

Methods And Materials: This study first reviews the experience of the OMS Department of the University of Maryland with ameloblastomas in children and then reviews the literature on this subject. The first part of the study was undertaken by a retrospective chart review of all patients with a diagnosis of ameloblastoma in the OMS Department between May 1991 and December 1999.

Oral leiomyosarcoma: review of the literature and report of two cases with assessment of the prognostic and diagnostic significance of immunohistochemical and molecular markers.

Leiomyosarcoma of the oral cavity is a very rare tumor that is associated with aggressive clinical behavior and low survival. In this paper, we report two new cases of leiomyosarcoma affecting the mandibular gingiva and mandible of a 35-year-old male and the mandible of a 51-year-old female. Given the difficulty in the histopathologic discrimination between benign and malignant smooth muscle tumors and the absence of reliable histologic parameters for prognostication of leiomyosarcomas, we evaluated the diagnostic and prognostic value of various immunohistochemical and molecular markers.

Current management of oral cancer. A multidisciplinary approach.

Background: Recent basic science discoveries have contributed to our understanding of the etiology of oral cancer and allowed us to consider innovative approaches to therapy.

Methods: The authors evaluated and summarized current approaches to the management of oral cancer, emphasizing the multidisciplinary team approach to coordinate surgery, radiation therapy and chemotherapy. Current concepts in management, including complications of therapy, are described.

Surgical management of facial nerve injuries.

The comprehensive management of facial nerve injuries requires a surgeon with a number of available methods of reconstruction at his or her disposal. Comprehensive evaluation or documentation of injury is required to determine the most appropriate timing and method of surgical intervention. The majority of nerve injuries are limited, and direct repair or simple nerve grafting are the indicated treatment modalities.

Management of oral squamous cell carcinoma treated with inadequate excisional biopsy.

Purpose: When an initial "excisional biopsy" has been performed on a primary oral carcinoma, microscopic tumor may remain and the usual landmarks that enable the surgeon to plan his safe margin are destroyed. This article analyzes the impact that such a biopsy may have on treatment and patient outcome.

Patients And Methods: A retrospective chart review of a consecutive series of 350 oral cancer patients treated by 1 surgeon in an 8-year period identified 33 (9.

Management of auricular hematoma using a thermoplastic splint.

Several methods have been described in the literature for the management of acute auricular hematoma. Herein, we review the pathogenesis of auricular hematoma, describe the various treatment modalities, and report a case in which a thermoplastic splint was used to prevent recurrence of hematoma in a patient with immune thrombocytopenic purpura.

Differential diagnosis between monomorphic clear cell adenocarcinoma of salivary glands and renal (clear) cell carcinoma.

Clear cell adenocarcinoma of salivary glands (CCASG) is a relatively rare tumor, composed entirely of clear cells of putative ductal origin. It bears striking morphologic similarities to renal cell carcinoma (RCC) of clear cell type on hematoxylin and eosin stains. Differentiation between CCASG and metastatic RCC to the salivary glands has been considered problematic or even impossible on morphologic grounds.

Ischemic heart disease.

Imbalances between myocardial oxygen delivery and oxygen demand result in ischemic heart disease. Accurate stratification of risk for permanent myocardial injury and appropriate choice of therapy are critical in the successful management of ischemic heart disease. Dental therapy can be performed safely for most ambulatory patients with ischemic heart disease.

Polymorphous low-grade adenocarcinoma of the sublingual gland.

A case of polymorphous low-grade adenocarcinoma occurring in the sublingual gland is described, followed by a brief discussion on the differential diagnosis. This is the first case ever reported of this entity occurring in the sublingual gland. This paper brings into question the early belief that this tumor is restricted to intraoral minor salivary glands.

Vertical ramus compartment resection of the mandible for deeply invasive tumors.

Purpose: Vertical ramus compartment resection of the mandible is indicated in the management of pathology that originates in the ascending ramus or condyle of the mandible and invades the pterygomaxillary fossa, infratemporal space, parapharyngeal space, masseter muscle, or medial pterygoid muscle. This article describes the technique, presents a review of the relevant literature, and reports the outcome of five cases.

Patients And Methods: A retrospective review of all cases operated on by the senior author (R.

Implants in the medically challenged patient.

Proper patient selection and careful technique will always be the marks of quality implant dentistry providers. The implications for therapy, of existing systemic disease or systemic therapies have been described in this article. All health care delivery provided by dental practitioners must take into account, always and foremost, the patient.