By John M. DelGaudio, Amy Y. Chen (auth.), William C. Wood, Charles A. Staley, John E. Skandalakis (eds.)
Modern organic knowing is the root for a multimodality remedy 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 accordance with an figuring out of either the anatomy and biology of tumor development. It offers the local anatomy to permit tailoring of the operation as demanded.
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Extra info for Anatomic Basis of Tumor Surgery
After the surgical specimen is removed, it is oriented with sutures for the pathologist. Meticulous homeostasis is obtained with the electrocautery and suture ligation with chromic sutures. Deep cautery in the tonsil bed is avoided because of proximity of the internal carotid artery. These wounds can be left to granulate, or smaller wounds may allow primary mucosal closure with 3–0 Vicryl or chromic sutures. External Approaches Tumors in the posterior oral cavity or oropharynx and larger tumors of the anterior oral cavity require additional surgical exposure than can be provided with peroral approaches.
The mandible is exposed, usually by a lip-splitting incision. The mandibular periosteum on either side of the proposed incision is elevated with a periosteal elevator. 23 canine or premolar for paramedian osteotomies, and a central incisor for midline osteotomies). Osteotomies between adjacent teeth are not performed because of the risk of devitalizing both teeth. The bony cut is marked on the mandible, designed to extend through the extraction socket. A stair-step pattern affords a greater surface contact area for osteosynthesis.
Healing of the defect by secondary intention is possible, but attempts should be made to cover the exposed mandible with advancement of mucosa. Full-thickness defects that communicate with the neck may require ﬂap closure with a platysma ﬂap, sternocleidomastoid ﬂap, or free tissue transfer. Tracheotomy generally is not required unless a large amount of ventral tongue is removed, resulting in tongue edema, or a large bolster is necessary, resulting in posterior displacement of the tongue. The use of a temporarily placed nasopharyngeal trumpet to stent the oropharyngeal airway is an alternative to tracheotomy in managing the possibly narrowed upper airway after anterior ﬂoor of mouth resection.
Anatomic Basis of Tumor Surgery by John M. DelGaudio, Amy Y. Chen (auth.), William C. Wood, Charles A. Staley, John E. Skandalakis (eds.)