Cancer maxilla spreads to….LNs
Upper deep cervical & retropharyngeal
In case of cancer maxilla, pt CO…..
Early: dull aching pain, referred to teeth
Late: medial: unilateral masal obstruction, epistaxis
Ant: swelling of cheek
Sup: epiphora & proptosis
Mention 2 cystic dental tumors, their age & site
Periodontal cyst, adult, upper jaw
Dentigerous, children, lower jaw
MC site for ameloblastoma is….
Molar area of mandible
List comp of ameloblastoma
- Infection, ulcer, bleeding, fall of teeth
- Rare: pathological fracture
- Recurrence
- Malignant transformation (mixed tumor)
Mention INV & TTT for ameloblastoma
Inv: X ray (soap bubble, honey comb)
CT/MRI
Biopsy
TTT: excsion with a 1 cm tumor free margin & bone grafting
2nd MC congenital anomaly is….
Cleft lip/palate anomalies
Inv for CL/P is….
Antenatal diagnosis by US >18 wks gestation + CP
Describe timing for intervention in CL
In isolation, 6wks to 3mon
In syndromic ots, may be delayed upto 6 months
Alveolar repair can be done w/ the 1ry lip repair or at another stage
List goals of repair of CL
- Correct all lip defects
- Reconstitute orbicularis oris
- Restore anatomical landmarks
- Correct nasal defirmity
- Achieve symmetry in bilateral cases
Describe C/P of CP
- Impaired suckling, dentation
- Impaired speech: hearing loss, inadequate VP mech
- Recurrent infections due to aspiration
- Inadequate emptying of middle ear (abnormal levator palate insertion) recurrent otitis media+hearing loss
- Distorted facial growth
List goals of repair in CP operation & timing of operation
A. Closure of cleft: separate oral & nasal cavities, prevent aerophagia & reflux of oral contents into nasopharnyx
B. Speech/VP competence, inc palatal length & muscle repositioning, prevent maladaptive compensatory misarticulations
C. Facial growth: early palate repair adversely affect maxillary growth, outweighed by improvement in speech achieved by early correction
Early repair at 6-9 months is preferred to improve hearing & speech outcomes
Describe CP surgery
Paring edges
Suturing in 3 layers: nasal m, ms layer, oralm
Lateral relaxation incisions & fracture pterygoid hamulus to relax tenor palati
List muscles of soft palate
Levator veli palatini, tensor veli palatini, palatopharyngeus, palatoglossus, musculus uvulae
Mention INV for neck injury
Plain X-ray (FB, wide mediastinum, subcut emphysema, fracture), duplex, CT of skull, brain, angio, laryngoscopy, gastrograffin swallow
Describe TTT of neck injuries
- ABCDE
- Tnsion pneomothorax: insert needle in 2nd intercostal space
- Minor bleeding: compression
- Major bleeding: exploration & vascular repair
- Neurological damage: neck support & patient evaluation
- Esophageal & larngo-tracheal injury: surgery repair
Describe block neck dissection
Remove ALL LNs on one side of neck in one mass, also remove carotid sheath, IJV, Sternomastoid, lower part of parotid & submandibular salivary glands
We preserve carotid a, vagus n, accessory n.
In modified radical neck dissection…..are preserved.
Mention its indications
IJV & SMK
in thyroid carcinoma & bilateral BND IJV is preserved on less affected side to enable drainage of brain
List ind for suprahyoid block dissection
Cancer of lower lip, & early tip of tongue or floor of mouth
How to determine the depth of burn?
By type & sensibility of area
Mention signs of BCC conversion to SCC
Edges become everted rapid growth. LNs are hard & fixed
Mention disadv of radiotherapy in tongue cancer
Mucositis, dysphagia, osteonecrosis
Time for VP repair is…., but alveolar repair is…..
2-3yrs
7-10 yrs
