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SURGICAL APPROACH ON MALIGNANT TUMOR OF THE ORAL CAVITY AND PHARYNX
S.V.G. Bertesteanu, B. Popescu, D. Ionescu, C.R. Popescu, T. Ionescu, D. Mirea and R. Grigore
Background. Malignant tumors of the head and neck have an increasing incidence in the population worldwide, including population of Romania. From all the tumors of the head and neck region oral cavity and pharynx tumors, with extension towards the larynx, have a great impact on the overall survival rates, functional implications and quality of life of the patients. Despite early symptoms, patients have a tendency to present themselves to the specialist in late stages of the disease because of ignorance, fear of diseases or bad advice from unknowing persons. This situation is a great challange for the oncology team considering the poor prognosis of locally advanced cancer. Development of malignant tumors of the oral cavity and pharynx in specific anatomical regions leads to particular ways of approach for each tumor located in different regions of the head and neck. Surgery is the main method in locally advanced tumors of the oral cavity and pharynx alongside with neck dissection for regional metastasis in lymph nodes.
Material and methods. Tumor resection needs to be performed with oncological safe margins of resection which means that a good exposure of the site of the tumor needs to be obtained. In the case of oral cavity and pharynx tumors there are several possibilities of approach. T1 and T2 tumors can be resected by using a transoral approach. T3 tumors have a great local extension thus the need for a better exposure of the site of location through the check. The greater tumors in diameter, T4 tumors, need to be approached by a transmandibular procedure so that the entire tumors can be resected with oncological safe margins of resections. The authors present their experience with the locally advanced malignant tumors of the oral cavity and pharynx in Coltea E.N.T. Clinic.
Results. The use of the transmandibular approach in managing cases of locally advanced tumors of the oral cavity and pharynx has some complications that can be avoided if a proper surgical technique is used. Patients operated using the transmandibular technique have a good quality of life despite some complications associated with radiotherapy performed after surgery.
Keywords: cancer, transmandibular approach, oral cavity, pharynx