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Adjunctive Technologies in the Management of Head and Neck Pathology, An Issue of Oral and Maxillofacial Clinics of North America, E-Book

Adjunctive Technologies in the Management of Head and Neck Pathology, An Issue of Oral and Maxillofacial Clinics of North America, E-Book

Nagi Demian

(2014)

Additional Information

Abstract

Adjunctive Technologies in the Management of Head and Neck Pathology, An Issue of Oral and Maxillofacial Clinics of North America, E-Book

Table of Contents

Section Title Page Action Price
Front Cover Cover
Adjunctive Technologies in the Management of Head and\rNeck Pathology i
copyright\r ii
Contributors iii
Contents v
Oral And Maxillofacial Surgery\rClinics Of North America\r viii
Preface\r ix
Epidemiologic Trends in Head and Neck Cancer and Aids in Diagnosis 123
Key points 123
Changing epidemiology of head and neck cancer 123
Incidence 123
Risk factors for HNSCC 124
Tobacco, Alcohol, Pan 124
HPV 124
Other Contributing Factors 125
Diseases and syndromes associated with increased risk for HNSCC 125
Plummer-Vinson 125
Fanconi Anemia and Dyskeratosis Congenita 125
Age, sex, and race predilection of HNSCC 125
Anatomic sites of HNSCC 126
Tongue 126
Floor of Mouth 126
Precursor lesions of HNSCC 126
Premalignant Lesion 126
Premalignant Condition 126
Leukoplakia 126
Proliferative Verrucous Leukoplakia 128
Erythroplakia 129
Oral Submucous Fibrosis 129
Oral Lichen Planus 129
Autofluorescence tissue-imaging devices for screening of HNSCC and its precursors 130
Oral epithelial dysplasia 131
Prediction of prognosis, treatment response, and survival in head and neck cancer 133
Biopsy Evaluation 133
Histologic Subtypes of SCC 133
Conventional/keratinizing SCC 133
HPV-associated SCC (HPV+ OPSCC) 133
Verrucous carcinoma 134
Papillary squamous carcinoma 134
Basaloid squamous carcinoma 134
Sarcomatoid squamous carcinoma (spindled cell carcinoma) 136
Histopathology prognosticators in SCC 136
Margins 137
Lymph Node Metastases and Extracapsular Extension 137
Tumor staging 138
Diagnostically relevant immunohistochemical stains for head and neck pathology 138
Immunohistochemistry 138
Makers for Infections 138
Prognostic biomarkers for HNSCC 138
HPV and p16 138
Molecular alterations in HNSCC 139
Tp53 and EGFR 139
Acknowledgments 139
References 139
Use of Porous Space Maintainers in Staged Mandibular Reconstruction 143
Key points 143
Introduction 143
Clinical challenge 143
Technical innovations 144
Advantages of porous space maintainers 144
Implant fabrication 145
Case series 145
Clinical outcomes 146
Summary 148
References 148
Pitfalls in Determining Head and Neck Surgical Margins 151
Key points 151
Introduction 151
Historical perspective 151
Oral cavity cancer epidemiology 152
Margin assessment 152
Margin Measurements 152
Anatomic and Histologic Margins 152
Meeting with Pathologist: Tumor Mapping 154
Pathologic Assessment of Margins: Techniques 155
Bone Margins 155
Tissue Shrinkage 156
Excision Method 157
Good Margins 157
Margin Reporting 157
Therapeutic implications of positive margins 158
Future directions 159
Summary 160
References 160
Chemotherapy for Oral and Maxillofacial Tumors: An Update 163
Key points 163
Chemotherapy for early-stage disease 164
Chemotherapy for locally advanced resectable disease 164
Role of Neoadjuvant Chemotherapy 164
Role of Adjuvant Chemotherapy 164
Chemotherapy for locally advanced unresectable disease 164
Induction Chemotherapy Before Radiation Versus Radiation 164
Induction Chemotherapy Before Concurrent Chemoradiation 165
Role of Epidermal Growth Factor Inhibitors 165
Chemotherapy for metastatic or recurrent disease 165
Cytotoxic Chemotherapy 165
Targeted Therapy 166
Rare tumors 166
Osteosarcoma 166
Lymphoma 167
Giant Cell Tumor of the Jaw 167
Summary 167
Acknowledgments 167
References 167
Anti-Resorptive Osteonecrosis of the Jaws 171
Key points 171
Introduction 171
Osteonecrosis of the jaws is seen in patients without cancer who are naive to antiresorptive medications 172
Osteonecrosis of the jaws is seen in higher incidences in patients with cancer 174
Tori and exostoses are at-risk structures in patients taking antiresorptive medications and in those patients naive to anti ... 177
Untreated osteonecrosis of the jaws progresses to more advanced stages 180
Resection represents effective and first-line therapy for patients with osteonecrosis of the jaws 181
Mandibular segmental defects can be reconstructed in patients exposed to bisphosphonate medications 184
Teeth may be extracted in patients exposed to bisphosphonate medications without the subsequent development of osteonecrosis 186
Summary 188
References 188
Oral Surgery in Patients Undergoing Chemoradiation Therapy 193
Key points 193
Epidemiology 194
Chemotherapy 194
Radiation therapy 194
Preparations before the start of therapy 195
The Patient Receiving Chemotherapy 195
The Patient Receiving Radiation to the Head and Neck Region 195
Patient management during antineoplastic therapy 198
Myelosuppression 198
Mucositis 198
Neurotoxicity and Taste Alteration 199
Xerostomia 200
After chemotherapy and radiation therapy 200
Trismus 200
Prevention and treatment of osteonecrosis of the jaw bone 201
Oral Surgery in Irradiated Jaws 202
Prophylactic Hyperbaric Oxygen Therapy 202
ORN: Classification and Treatment 203
Dental Implant Placement After Radiation Therapy to the Head and Neck Region 203
Summary 205
References 205
Evaluation and Staging of the Neck in Patients with Malignant Disease 209
Key points 209
Introduction 209
TNM classification and staging 210
Considerations for N staging 211
Squamous cell carcinoma 212
Salivary gland cancers 213
Carcinoma of unknown primary 213
Evaluation of the neck for nodal metastasis 214
Ultrasound 214
CT and MRI Evaluation of the Neck 214
PET/CT 216
Sentinel Lymph Node Biopsy 217
Neck Evaluation During Post-therapeutic Surveillance 217
References 218
Update in Radiation Therapy for Oral and Maxillofacial Tumors and Dose Mapping 223
Key points 223
Introduction 223
Toxicity from RT 227
Summary 228
References 228
The Role of Bisphosphonates in Medical Oncology and Their Association with Jaw Bone Necrosis 231
Key points 231
The role of bisphosphonates in medical oncology 231
Mechanism of Action 231
Types of Bisphosphonates 232
Administration and Side Effects 232
Route of administration 232
Side effects 232
Absorption and half-life 232
Bisphosphonates in Multiple Myeloma 232
Bisphosphonates in Solid Tumors 233
Bisphosphonates in Metabolic Disorders 233
Other Bone-Modifying Agents 233
Associated risk of jaw bone necrosis with bisphosphonates 234
Pathogenesis 234
Acknowledgments 235
References 235
Nuclear Medicine Imaging Studies in the Diagnosis of Head and Neck Disease 239
Key points 239
Introduction to PET/CT imaging 239
Technical aspects of PET imaging 241
Typical images 242
PET imaging in DIONJ 243
References 244
Pharmacologic Modalities in the Treatment of Osteoradionecrosis of the Jaw 247
Key points 247
Introduction 247
Pathogenesis 247
Pharmacologic agents in ORN management 249
Hyperbaric Oxygen Therapy 249
Pentoxifylline and Tocopherol 250
Pentoxifylline 250
Tocopherol 250
Clodronate 250
Pentoxifylline and Tocopherol Combined Therapy With or Without Clodronate 250
Summary 251
References 252
Magnetic Resonance Imaging (MRI) in the Diagnosis of Head and Neck Disease 253
Key points 253
Introduction 253
Approach 253
Applications 254
Neoplasms and Masses 254
Infections 254
Skull Base and Temporal Bones 260
Vascular Lesions 260
Brachial Plexus 267
Summary 268
References 268
Index 271