Carcinoma of the jaws, derived from epithelial remnants of odontogenic epithelium and facial protrusions fused with cysts and enamel-forming cell tumor malignancies.
Clinical manifestations are.
1. Preferably in the mandible, especially in the mandibular molar area, a substantial mass appears at the onset site with rapid growth, no pinging sensation on palpation, and may have pressure pain.
2, may have toothache, local pain, invasion of the lower alveolar nerve can appear lower lip numbness.
3. Invasion of alveolar process may lead to loosening of teeth, loss of teeth, protrusion of tumor from alveolar fossa, and restriction of mouth opening when invading adjacent chewing muscles.
4. Regional lymph node metastasis may occur. It can be prevented and treated.
Etiology: Epithelial remnants and cyst and enamel-forming cell tumor malignancy originating from odontogenic epithelium and facial protrusion fusion.
Diagnosis.
1. swelling in the jaw area with rapid growth, pain, numbness of the lower lip, and loosening and loss of teeth.
2, Radiographs showed irregular worm-like destruction.
3, Pathological histological examination confirms the diagnosis.
Clinical manifestations.
1, Preferably in the mandible, especially the mandibular molar area, in the onset of the site of a substantial mass, rapid growth, palpation without pinging sensation, may have pressure pain.
2, may have toothache, local pain, invasion of the lower alveolar nerve can appear lower lip numbness.
3. Invasion of alveolar process may lead to loosening of teeth, loss of teeth, protrusion of tumor from alveolar fossa, and restriction of mouth opening when invading adjacent chewing muscles.
4. Regional lymph node metastasis may occur.
Laboratory examination: . For those with typical clinical manifestations and limited tumor, the examination case should be based on the examination frame “A”; 2. “and “C”.
Differential diagnosis.
1. Chronic osteomyelitis of the jaws with a history of inflammation and restorative changes of bone destruction and periosteal hyperplasia seen on X-ray. When clinical and X-ray cannot differentiate, frozen section should be made at the time of surgery to exclude central jaw cancer.
2.Neuritis is relatively rare, numbness is light and heavy at times, and there is no bone destruction on X-ray.
3.X-ray of central mandibular hemangioma shows flare-like changes in the mandibular mouth and enlargement of the mandible.
4, alveolar abscess has focal tooth and local redness, swelling, heat and pain dysfunction, but no lower lip numbness.
Complications: It can metastasize to submandibular and deep upper cervical lymph nodes, and also hematogenous metastasis to lung, and the prognosis is extremely poor.
Prevention: The etiology of oral cancer has not been fully understood yet, but the current consensus is that most of oral cancer is related to environmental factors, and some external factors such as heat, chronic injury, ultraviolet light, X-rays and other radioactive substances can become cancer-causing factors. In addition, internal factors such as neuropsychiatric factors, endocrine factors, immune status of the body and genetic factors are found to be related to the occurrence of oral cancer, therefore, the prevention of oral cancer lies in reducing external stimuli and improving the body’s ability to resist diseases. Therefore, it is necessary to be highly vigilant and conduct necessary auxiliary examinations such as radiographs as soon as possible, and if necessary, extract a tooth of disease origin and scrape a piece of tissue from the alveolar socket for pathological examination. In addition, surgery is preferred for this disease, while radiation therapy or chemotherapy can help improve the healing rate, but the latter two should not be taken as the main treatment measures, so as not to miss the treatment time, let alone adopting some partial prescriptions to stimulate the growth of the swelling and delay the treatment or even lose the treatment opportunity.
Treatment: Surgery is the main method to treat jaw cancer, generally selective cervical lymph node dissection should be performed, which can be combined with radiotherapy or chemotherapy after surgery. For general surgery, sulfa drugs (such as cotrimoxazole) or drugs mainly acting on Gram-positive bacteria (such as red enzyme, cyanase, etc.) are used for prophylactic anti-infection; for larger surgery, simultaneous bone grafting or more complicated repair, combined drugs are generally used, which are more commonly used as: drugs acting on Gram-positive bacteria (such as cyanase) + drugs acting on Gram-negative bacteria (such as gentamicin) + drugs acting on anaerobic bacteria (such as gentamicin). Drugs acting on anaerobic bacteria (e.g. methotrexate); severe pre- and post-operative infections or large surgical wounds and complex repair methods can be selected according to clinical and drug sensitivity tests. Chemotherapy can be applied preoperatively or postoperatively, as its side effects are more serious, it should be applied under close observation of blood picture under the guidance of physicians.
Cure criteria
1.Cure: After treatment, the primary tumor and metastasis source have been completely removed or disappeared, and the trauma surface has been basically repaired.
2.Improved: After treatment, the tumor shrinks and the symptoms are reduced.
3.Not cured: After treatment, the tumor does not shrink and the symptoms do not improve.