surgical aspect of oral tumors

7/31/2019 Surgical Aspect of Oral Tumors

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Surgical Aspect of

Oral Tumors


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Surgery is often the first line treatment option

for oral cancer. Oral cancer that is detected at anearly stage, before the cancer cells have spread toother areas of the body, is treated with surgery.

Numerous surgical techniques are available toremove a tumor and restore the appearance andfunction of any tissues affected by either the canceror the treatment. Many oral cancer surgery patientsare often concerned about disfigurement; but recentadvances in reconstructive surgery mean that

appearances can be restored, sometimes with little orno sign of change.


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Surgical Oncology Procedures

Depending on the stage of oral cancer, your

doctor may recommend one or more of thefollowing procedures.
http://www.cancercenter.com/oral-cancer/oral-cancer-staging.cfmhttp://www.cancercenter.com/oral-cancer/oral-cancer-staging.cfm


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Tumor resection: An operation to remove the entire

tumor. Some normal tissue surrounding the tumor isalso removed to ensure that no cancer cells remain inthe body. A small tumor that is easily reached canoften be removed through the mouth. For tumors

that are larger or harder to reach, an incision may bemade in the neck or jawbone.


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Mohs micrographic surgery: This surgical oncology

procedure, also known as micrographic surgery, maybe recommended for some cancers of the lip. Withthis approach, a tumor is removed in very thin slices,with each slice examined under the microscope forthe presence of cancer cells. The process continues

until no cancer cells are seen. This gradual approachhelps prevent the removal of normal tissue as well aschanges in appearance.


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Full or partial mandible (jawbone) resection: When a

tumor has grown into the jawbone, a mandibularresection, or mandibulectomy, may be needed. In thisprocedure, all or part of the jawbone is removed. Ifthe jawbone appears normal in an X-ray and there isno other evidence of cancer cells in the area, then

just a small piece of the bone may be removed.However, if the X-ray shows cancer in the jawbone,then the entire bone may need to be removed.


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Glossectomy: This type of cancer surgery, which

involves removal of the tongue, is used to treatcancers of the tongue. When a tumor is very small,only partial removal may be necessary. Larger tumorsmay require removal of the entire tongue.


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Maxillectomy: This operation removes all or part(partial maxillectomy) of the hard palate, the frontof the roof of the mouth. A special denture can becreated to fill the hole created by this surgery. Yourdoctor will likely refer you to a prosthodontist, aspecialized dentist, who can make a prosthetic

tailored to your exact mouth shape.


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Laryngectomy: This surgical oncology procedureinvolves removing the voice box along with the

primary tumor. When a large tumor has grown on thetongue or in the oropharynx, it may be necessary toremove some tissue that is involved in swallowing toensure that all the cancer cells are removed. As aresult of this process, food may enter the windpipe

(trachea) and then the lungs, which may causepneumonia. When the risk of pneumonia is high, alaryngectomy may be recommended. With thisprocess, the windpipe is attached to a hole in the skinof the neck for breathing. A laryngectomy does not

always mean losing the ability to talk. In fact, thereare several techniques available to restore vocalcapabilities afterwards.


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Neck dissection: This type of oral cancer surgery isused to remove lymph nodes in the neck if cancer has

spread to this area. Depending on the size and extentof cancer in the lymph nodes, different proceduresare recommended:

Partial or selective neck dissection to remove only a fewlymph nodes

Modified radical neck dissection to remove most lymphnodes on one side of the neck between the jawbone andcollarbone, along with some muscle and nerve tissue

Radical neck dissection to remove almost all lymph nodes onone side, with more extensive removal of muscle, nerves, andveins


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Other Surgical Oncology

Procedures for Oral Cancer


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Pedicle or free flap reconstruction: When a largetumor is removed, the mouth, throat, or neck mayrequire repair of some kind. Sometimes, a skin graftmay be done. Here, a thin slice of skin is taken fromthe thigh and reattached in the oral cavity area inneed of repair. When the defect is larger, a piece of

muscle, with or without skin, can be shifted from anearby area, such as the chest or upper part of theback.


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Tracheostomy: If a tumor in the oropharynx is toolarge to remove completely, a hole can be opened in

the windpipe and front of the neck to allowcomfortable breathing. Sometimes, removing a tumormay lead extensive swelling in the neck afterwards.In this case, your surgical oncology team can perform

a temporary tracheostomy, in which an incision ismade in the trachea, can ease breathing until theswelling goes down.


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Gastrostomy tube: A gastrostomy tube is a feedingtube that can be inserted directly into the stomach.This approach may be recommended if a cancer in theoral cavity or oropharynx is preventing swallowing. Agastrostomy tube can ensure that an individual isgetting adequate nutrition.


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Dental extraction and implants: When radiation isused to treat oral cancer, it may be necessary to

remove teeth, because exposure of unhealthy teethto radiation may lead to serious problems. A completedental evaluation is always done for patients receivingradiation therapy for oral cancer.If your surgical

oncology team removes your jawbone is removed andreconstructs it using bone from another part of thebody, dental implants might be placed in the newbone. These implants are hardware that prostheticteeth can attach to, either during reconstructivesurgery or later.


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As with all cancer treatments, surgery for oralcancer can have some side effects. Your doctor willexplain these potential side effects and discuss waysto help minimize or heal any problems you experience.

Many times, surgery to remove a primary tumor issimple, and the only side effect is pain that goes awayshortly afterwards. However, when the procedure ismore complicated, there is often a risk of infection

and there may be problems with eating or speaking.Certain procedures carry particular risks:

Side Effects of Surgery forOral Cancer


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Glossectomy: Partial removal of the tongue usuallydoesnt eliminate the ability to speak, but speech may

not be as clear. Swallowing may also be affected.Both of these oral cancer surgery side effects can beaddressed withspeech therapy. If the entire tongueis removed, then both speaking and swallowing are nolonger possible. However, reconstruction surgery and

rehabilitation can help restore both of these abilitiesto some extent.
http://www.cancercenter.com/oral-cancer/physical-therapy.cfmhttp://www.cancercenter.com/oral-cancer/physical-therapy.cfmhttp://www.cancercenter.com/oral-cancer/physical-therapy.cfm


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Laryngectomy: Removing the voice box means that aperson no longer has the ability to speak in a regularway. However, there are several ways to restorevoice. Your doctor can discuss the many options forvoice restoration with you before you begintreatment for oral cancer.


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Facial bone removal: Removing part of the facialbone structure may leave visible changes that can beupsetting. Recent advances in facial prostheses andplastic (reconstructive) surgery mean thatappearance can be restored. These procedures canalso help restore speech. These cutting-edgeprocedures are helping patients better manage cancersurgery side effects and live a long life filled withhealth and well-being.

surgical aspect of oral tumors

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