Prof. Liu Jianhua PhD. MS. DDS. Dept. of Oral-Maxillofacial Surg. - PowerPoint PPT Presentation

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Prof. Liu Jianhua PhD. MS. DDS. Dept. of Oral-Maxillofacial Surg.

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Prof. Liu Jianhua PhD. MS. DDS. Dept. of Oral-Maxillofacial Surg. & Dentistry First affiliated hospital Zhejiang university school of medicine – PowerPoint PPT presentation

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Title: Prof. Liu Jianhua PhD. MS. DDS. Dept. of Oral-Maxillofacial Surg.


1
Prof. Liu JianhuaPhD. MS. DDS.Dept. of
Oral-Maxillofacial Surg. DentistryFirst
affiliated hospitalZhejiang university school of
medicine
2
Tumorsin oral maxillo-facial region
  • Namingoriginal tissue, biological type,
    position. Such as squamous cell carcinoma of
    right tongue
  • Critical t. biologically benign tumor, but has
    malignant tendency and infiltrating growth. such
    asameloblastoma, mixed tumor, papiloma.

3
A mass in left submandibular region for 5 years,
slow growing, with no symptom. Diagnosis?
Further examination?
4
Left tongue ulcer 3 months, painful, Poor
condition of oral cavity, what to do next?
5
Black lesion in soft palate, grows rapidly recent
3 months, shall we make a biopsy?
6
  • manifestations diagnosis
  • Judgement of a mass on patient
  • 1)tumor / not tumor(inflam. TB, malformation,
    etc.)
  • 2)benign / malignant

7
  • Differentiation
  • benign tumor
    malignant tumor
  • Age any age
    carcinoma/agednesssarcoma/young
  • Growth speed slow
    faster
  • Growth manner bulge
    invasive
  • Boundary smooth,movable
    unclear,unmovable
  • Symptom generally no
    painful/numbness/funct.limmit
  • Metastasis no
    maybe
  • Body affect generally no organ
    destroy/system destroy
  • Histology struct. well differentiated
    worse diff./abn. nuclear
  • close to
    norm.cell/tissue
    division

8
benign/malignant?
9
benign/malignant?
10
  • Means of diagnosis
  • 1)case historyarise,progress
  • 2)clinical examinelook?touch? listen to(with
    stethoscope )
  • 3)imageX-ray,panoramic radiograph,CT,MRI,
    DSA,B-ultrasonic,PET/CT
  • 4)puncturefor liquid
  • 5)biopsyno melanoma/parotid g.
  • 6)tumor markersCEA, AFP, CA50/125/153/242/724
    etc.

11
  • treatment
  • 1)treatment principle benign tumorsurgery
    firstmalignant t.combined
  • 2)methods
  • Surgery. safe edge1 cm for malignacy
  • Radiotherapy. oral preparationremove ill tooth
    and metal crown fill decayed tooth tooth
    cleaning---(to prevent jaw infection, necrosis,
    redial beam focus)
  • Chemotherapybefore,during, post-operation
  • othersthermotherapy./immunother. /herbs/
    biotherapy

12
  • Prevention of oral cancer
  • eliminate or reduce carcinogenincomplete tooth
    root or crown?displaced tooth?sharp tooth
    edge?poor denturehot food?tobacco and
    alcoholenvironment contamination(air
    pollution,paint,glue)psycho-problem.
  • treat precancerous lesion in timemucosa
    erythema?leukoplakia ?oral lichen planus
    ?papilloma etc.
  • investigate vulnerable population and give
    education

13
  • questionhow to prevent oral cancers?

14
??? Oral Maxillofacial cyst???????
15
Commonness of Cysts????
  • ???wall?????content(??/???liquid/solid)
  • ????
  • ????
  • ???????????????expansile absorbing

16
????????????sebaceous cyst
  • ??pathogeny???sebaceous gland?????,?????----???re
    tentive???
  • ?????????????pigment dot????----?????
  • ????shuttle??--??????(??)

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??????????dermoid / epidermoid cyst
  • ?? ??embryo?????remnant?????(?????)
  • ??????????----?????????----?????????????----?????
    ??????????
  • ?? ???????????????----????????

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????????thyroglossal tract cyst
  • ???????----?????----????----??????,?????????????
    ----???????----??????
  • ????1-10?gt??? ???----????????????????,??,???,????
    ????,??----??/????,B????----?----???

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  • (????)
  • ?????????,???,??,?????
  • 1??????????,???????
  • 2?????????,?????
  • ?-131/?-99????????
  • ??
  • ???????????
  • ???????----?????

25
? ????branchial cleft cyst
  • ?? ?????----5???----4???----??????----??
  • ???? 20-50?(????????)???,???fluctuate,??????----?
    ?,??----???,??----???fistula(??????),???congenital
    ----??????(???????),??----??/???/??????,B??

26
??????maxillary cyst
  • ???????odontogenic jaw cyst
  • ????/?----????(???????????)
  • ????????non-odontogenic
  • ?????????----????
  • ??----??????intra-bleeding

27
??????? odontogenic jaw cyst
  • ????(radicular cyst)
  • ??????----???----???????----????----??
  • ????(residual cyst)??????????

28
  • ???? (primordial cyst)
  • ???????----?????----??
  • ???? (dentigerous cyst)
  • ????????????----??
  • ???? (keratocyst)
  • ????/????----??(????,??,??/???)

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????clinical characteristics
  • ????????----??????----???----???----??

32
??
  • ??
  • ?????
  • X?
  • ????----?????,??
  • ????----?8?/?????
  • ????----?????
  • ????----?8?/?????

33
??
  • ????
  • ??/??,??/??
  • ???????/?????/???????
  • ????

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??? ?????????benign tumor tumor-like lesion
  • ??????/?????????????????,????(???????)?

40
?? ????
41
???nevus
42
???nevus
  • ??????
  • ???????????????
  • ???---???,?????????,?????
  • ???---??????????????---???
  • ???---??????????,????

43
???(epulis)
  • ????/??????---????(?????)
  • ????---??????????,???
  • ???---?????????,????
  • ???---????,????(?????)
  • ???? ???---??????????

44
??????
45
(?)???????(ameloblastoma)
  • ????????????????????????(?)/??(???),????
  • ????????,???/??,????,??????----??????(????????)??
    ??(?)?
  • ??X????----????????,????,?????,?????
  • ?????,?????0.5cm????????
  • ?????????????????

46
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49
hemangioma ???
  • 1) authentic tumor
  • 2) account for 60 of body hemangiomas
  • 3) head vs.body? 19?
  • 4) most disappear before 10 year-old
  • 5) surgery or not?

50
Clinical characteristics
  • 1) newbornstrawberry like on skin
  • 2) rapid growthafter 1 month
  • 3) stillness or shrinkingafter 1 year
  • 4) disappear50-60 within 5 year 75 within 7
    year 90 within 10 year.
  • 5) end of disappear10-12 year
  • Question shall we recommend surgery?
  • Advantage ? Disadvantage?

51
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52
vascular malformation
  • A) venular(???) malformation -- 50200um, former
    grape wine splash(??????)
  • Clinic characteristics
  • Pressdisappear, distinguish from nevus(???)

53
grape wine splash
sponge-like
54
B) venous malformation(????)
  • Former cavernous (sponge-like????) hemangioma
    (old textbook)
  • clinic characteristics
  • 1) Compress test
  • 2) Head down test
  • 3) Puncture
  • 4) Vein calculi (stone)
  • Question is angiography(????) helpful?

55
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venous malf-before after surgery
58
c)Arterio-venous malformation
  • Or congenital(???) arteriovenous malf.
  • Former grape-vine-like hemangioma??????.
  • Outstretched artery and vein connecting directly,
    omitting capillary net.
  • Clinic characteristics
  • 1) earthworm like 2) throbbing/pulsate
  • 3) souffle (???,caused by vortex)

59
Treatment methods
  • 1) surgery once or several times
  • 2) intra cavity injectionfor venous malf., with
    Bleomycin, maximum 6mg/once.
  • 3) hormone / isotopefor infant within 1
    year-old.
  • 4) laser lightfor superficial lesion.
  • 5) embolism of blood vesselglutin(??)sponge/
    metal spring, reopen in a few days.
  • 6) trans-catheter(??)arterial embolizationunder
    DSA, dangerous.
  • Question can ligation of external carotid artery
    cure arteriovenous malf.?

60
(?)???????
  • (????neurolemmoma)
  • ??????,?????Schwannoma?
  • ??????/??,??(????),????,????????(????),????????,?
    ??????,?????????????????
  • ??????????????????

61
?????neurofibroma
  • ??????????????
  • ?????????????,??,??????,????????,??,????????,????
    ???????????gt1.5cm, gt56??----??????(??)?
  • ???????????

62
Before sugr.
Before sugr.
After sugr.
63
(?)??????osteogenetic tumor
  • ??????(?????)
  • ????(????)
  • ????????(????)

64
??????ossifying fibroma
  • ??????????????,???????????????
  • ???????,??,??gt??,??gt??,????,???,X????,?????
  • ????????????----????,??,??gt??,X?????,???????
  • ??????/?????

65
(?)?????
  • ????????????????(mixed tumor).
  • ??????gt???gt?????????,????????????????
  • ?????

66
??? ????
  • ? ???(?????30)
  • (carcinoma of tongue)
  • ????-??????-????
  • ????,??,??
  • ????????
  • ??????????????????????????? ?????????????????
    ???
  • ??????(??????????????)??????????????

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  • ?????gingival(?25)?????,?????
  • ????buccal(?20)?????????
  • ????palate(10)?????????
  • ?????oral floor????,????

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??????carcinoma of maxillary sinus
  • ???????????????????????????
  • 1)????????
  • 2)????????
  • 3)???????
  • 4)????????????
  • 5)???????
  • ????????????????

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????carcinoma of lip
  • ??????????crater???/???cauliflower???
  • ??????(1??)???????????????

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  • ?????????????-??????
  • ??????fibrosarcoma????
  • ??????osteosarcoma????????????
  • ????????malignant lymphoma
  • HLNHL15(NHL???)
  • ???????,???????????????????????????
  • ???????
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