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 one ebook that gives an anatomic foundation and outline of tumor surgical procedure according to an knowing of either the anatomy and biology of tumor development. It provides the local anatomy to permit tailoring of the operation as demanded.
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Additional info for Anatomic Basis of Tumor Surgery
Perioral Resection Resection using the perioral route is limited to those tumors that can be adequately exposed, removed with adequate margins, and reconstructed through the mouth without additional incisions. This mainly includes small anterior tongue tumors Surgical Applications (T1 or T2), small ﬂoor of mouth tumors, small hard and soft palate lesions, and tonsil tumors. Limited anterior mandibular alveolar ridge resection in conjunction with ﬂoor of mouth resection may be performed periorally, although better exposure is afforded by translabial approaches.
The patient is under general anesthesia and nasotracheally intubated. Tracheotomy can be performed but is not usually necessary for transoral resection or early ﬂoor of mouth lesions. For all but superﬁcial T1 tumors, unilateral or bilateral selective neck dissections are performed prior to addressing the ﬂoor of mouth primary tumor. The alveolar ridges are retracted apart using a posteriorly placed bite-block or side-biting oral retractor. The cheeks are retracted with cheek retractors. The tongue is retracted superiorly.
In the case of a tongue base tumor, a vertical pharyngotomy is performed, exposing the base of tongue. The tumor is then excised under direct visualization. As mentioned, more anterior exposure can be obtained by incising the ﬂoor of mouth musculature and the mucosa along the gingivolingual sulcus or by performing a lateral mandibulotomy. After the tumor is resected, frozen-section margins are evaluated. Good hemostasis is obtained. Closure of the defect depends on the extent of tissue loss. When possible, primary closure is preferred, but for large defects ﬂap closure is necessary.