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DISEASES OF THE ORAL CAVITY

DISEASES OF THE ORAL CAVITY. Prof. İlhan TOPALOĞLU Otolaryngology Department Yeditepe University School of Medicine. ANATOMY OF THE ORAL CAVITY. anterior : vermillion border of the lips posterior: oropharynx oropharyngeal isthmus : (superior) junction of the hard and soft plates .

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DISEASES OF THE ORAL CAVITY

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  1. DISEASES OF THE ORAL CAVITY Prof. İlhan TOPALOĞLU Otolaryngology Department Yeditepe University School of Medicine

  2. ANATOMY OF THE ORAL CAVITY • anterior : vermillion border of the lips • posterior: oropharynx • oropharyngeal isthmus : (superior) junction of the hard and soft plates . (lateral) anterior tonsillar pillars (inferior) the line of the circumvallate papillae

  3. ANATOMY OF THE ORAL CAVITY 1- Lips 2- Anterior portion of the tongue 3- Buccal mucosa 4- Upper and lower alveolar ridges 5- Retromolar trigone 6- Floor of the mouth 7- Hard palate

  4. Exam: Lips

  5. Exam: Lips-palpation • Color, consistency • Area for blocked minor salivary glands • Lesions, ulcers

  6. Pyogenic granuloma

  7. Fibroma

  8. Lip cancer

  9. Lower lip carcinoma

  10. CANCERS OF THE LIP • 88-98% lower lip • 2-7% upper lip • 0,09-6,1% oral commisure • Male and older than 60 years old  • SCC  • Basal cell ca, melanoma, minör salivary gland tm.

  11. Sensory innervation of the tongue • 1 – chorda tympani and lingual nerve • 2 – glossopharyngeal nerve • 3 – vagal nerve

  12. Exam: Tongue

  13. Exam: Tongue • You may observe lingual varicosities

  14. Exam: Tongue • You may observe geographic tongue (erythema migrans)

  15. Exam: Tongue • You may observe drug reaction

  16. Exam: Tongue • Observe signs of nutritional deficiencies

  17. Leukoplakia

  18. Hemangioma

  19. CANCERS OF TONGUE • Lateral border • Ocult met. 30% • Stage, nodal metastases, lenfovasculer, perineural invasion and thickness of tumor are important prognostic factors.

  20. CANCER OF THE ANTERIOR PORTION OF THE TONGUE

  21. Tongue ca.

  22. Tongueca.

  23. Examination: Buccal Mucosa • Linea alba • Stenson’s duct

  24. Lichen Planus

  25. ALVEOLAR RIDGE

  26. Ameloblastoma

  27. Gingival cyst

  28. Mucoepidermoid tumor

  29. Exam: Retromolar trigone

  30. Exam: Retromolar trigone Edentulous

  31. Exam: Floor of mouth

  32. Palpation of the floor of the mouth

  33. Exam: Floor of mouth • Visualize, palpate - bimanually • Wharton’s duct • Must dry to observe • Does “lesion” wipe off? • Where are the two most likely areas for oral cancer? • lateral border of the tongue • Floor of mouth

  34. Squamous Cell Carcinoma

  35. FLOOR OF THE MOUTH CA. • Incidance of mandibular invasion rate is high • Ocult met  10-30% • Primary resection of the floor of the mouth is peformed with ipsilateral or bilateral neck dissection (if the tumor is located at the midline)

  36. Exam: Hard palate

  37. Median Palatal Cyst

  38. CANCER OF THE HARD PALATE • uncommon • SCC and Adenoid cystic ca • Misdiagnosed as maxillary sinus tm • Incidance of neck metastases is low • Elective neck treatment is unnecessary • Prostodontist

  39. ORAL PREMALİGNANCY • Leukoplakia • Erythroplakia • Mucosal atrophy

  40. MALIGNANT LESIONS • SQUAMOUS CELL CARCINOMA • VERRUCOUS CARCINOMA • MINOR SALIVARY GLAND TUMOURS • SARCOMATOID CARCINOMAS • MALIGNANT MELANOMA

  41. Risk factors for oral cavity and oropharyngeal cancer include: Cigarette Alcohol Exposure to the human papilloma virus (HPV) or Epstein-Barr virus (EBV) ionizing radiation Prolonged sun exposure, especially linked to cancer in the lip area and skin cancer. Fair skin, also linked to lip cancer and skin cancer. Age. People over the age of 45 years old are at increased risk for oral cancers (though it can develop in people of any age). Poor nutrition. Irritation from poorly fitting dentures in people who use alcohol and tobacco products. Chewing betel nuts, a nut containing a mild stimulant popular in Asia. Weakened immune system. Vitamin A deficiency. A rare condition called Plummer-Vinson Syndrome, which involves iron deficiency and causes difficulty swallowing. Gender. Men are more likely to get lip cancer than women. lichen planus discoid lupus erythematosus dystrophic epidermolysis bullosa ETIOLOGY

  42. Symptoms • Otalgia • Odynofagia • Bleeding • Dysfagia • Loss of teeth • Restriction of mouth movement • Trismus

  43. EPIDEMIOLOGY • 95 % SCC • 95 % patiet  40 years old • Mean age 60 years old • After the treatment of oral cavity ca if the patient doesn’t give up smoking, second primary or recurrence rate is 40 %

  44. TREATMENT • surgery • RT • surgery + RT • KT + RT • Surgery + RT + adjuvant KT

  45. The last cigarette

  46. DISEASES OF OROPHARYNX Prof. Dr. İlhan TOPALOĞLU Otolaryngology Department Yeditepe University School of Medicine

  47. ANATOMY OF THE OROPHARYNX Anterior : oropharyngeal isthmus; (superior) junction of the hard and soft plates . (lateral) anterior tonsillar pillars (inferior) the line of the circumvallate papillae İnferior: the plane of the hyoid bone

  48. OROPHARYNX SUBSIDES • Softpalateanduvula • Base of thetongue • Tonsillarregion (tonsillarfossaeandpillars) • Oropharyngealwalls (lateralandposterior)

  49. Waldeyer's ring • Waldeyer's tonsillar ring (or pharyngeal lymphoid ring) is an anatomical term describing the lymphoid tissue ring located in the pharynx and to the back of the oral cavity. • It was named after the nineteenth century GermananatomistHeinrich Wilhelm Gottfried von Waldeyer-Hartz.

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