Download Anatomic Basis of Tumor Surgery by John M. DelGaudio, Amy Y. Chen (auth.), William C. Wood, PDF

By John M. DelGaudio, Amy Y. Chen (auth.), William C. Wood, Charles A. Staley, John E. Skandalakis (eds.)

Modern organic figuring out is the foundation for a multimodality therapy of a tumor. 'Anatomic foundation of Tumor surgical procedure' is the single e-book that offers an anatomic foundation and outline of tumor surgical procedure in response to an realizing of either the anatomy and biology of tumor development. It provides the neighborhood anatomy to permit tailoring of the operation as demanded.

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This approach allows good access to the lateral posterior floor of mouth, posterior tongue and tongue base, tonsil, and soft palate. It also provides good access to the parapharyngeal space. After soft tissue resection is completed, the defect is closed with either primary closure, split-thickness skin grafting, or a flap. Closure of the mandibulotomy involves replacement of the plates and screws. The lip-splitting excision is closed as previously described. The patient is given a soft diet for approximately 6 weeks postoperatively to allow for appropriate healing of the mandibulotomy.

A 1 cm cuff of floor of mouth mucosa should be preserved laterally for ease of closure at the end of the procedure. The submandibular duct orifice should be included with the mandibular segment. The deep incision is carried through the floor of mouth musculature, separating the muscular sling from the mandible. This allows significant distraction of the mandibular segments. 39 The lingual and hypoglossal nerves should be identified and preserved if possible. The mucosal incision can be carried superiorly along the anterior tonsillar pillar to include the tonsil or extended up onto the soft palate to access the superior parapharyngeal space.

26 37 38 Chapter 1 Oral Cavity and Oropharynx be resected. An oscillating saw is used to perform the osteotomies, first performing the vertical limbs and then the horizontal osteotomies. The horizontal limb of the osteotomy is angled slightly inferiorly as needed to remove more of the medial cortex of the mandible. In dentulous patients, the osteotomy site is made below the tooth roots. Care should be taken to ensure that the osteotomies are completely through the bone and that undue force is not placed on the bone to complete the osteotomies to avert possible fracture of the residual inferior cortex.

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