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  1. How do you approach a pathologic lesion?
    • blood: PTH, Alkaline phosphatase, rarely diagnostic
    • Imaging: angiography, contrast, MRI(soft tissue), scans
    • Aspiration: simple, distinguish benign from malignant
    • Biopsy: most definitive
  2. What is segmental resection?
    • geometric removal of tissue-> aggressive tumors
    • marginal: just alveolar process
  3. What is partial resection?
    • remove to leave gap-> large tumors
    • must reconstruct
  4. What is carnoy's soln?
    chemical coagulation: 60% EtOH, 30% Chloroform, 10% acetic acid
  5. What are indications for marsupialization?
    • prevent injury, devitalization of teeth, erupt teeth
    • difficult surgical access
    • pathologic fracture
    • med compromised
  6. Which MRI is good for fluid contrast?
  7. What are risk factors of oral cancer?
    tobacco, HPV, EBV
  8. What type of oral cancer does EBV increase risk?
    Type II nonkeratinizing NPC (nasopharyngeal)
  9. What kind of leukoplakia is premalignant?
  10. What is most erythroplakia?
    invasive carcinoma, carcinoma in-situ or sever dysplasia
  11. Adv/disadv of surgery?
    • physical remove, pathology, quick, no toxicity
    • morbidity, anesthetic, may miss some
  12. Adv/disadv of radiation?
    • tx both cancer and adj areas, preserves appearance function, sick elderly more tolerable
    • long, toxicities, no pathology evaluation
  13. adv/disdv of chemo?
    • systemic, presever appearance/function
    • not effective for all, long tx, toxicity, no pathology eval
    • not curative alone
  14. What are access aproaches for oral cancer surgery?
    • intaoral: no scarring, limited access
    • lip-splitting: best access
    • visor flap: neck scarring only, long incision.
  15. What is en bloc resection?
    • geometric
    • marginal: alveolar process
  16. What is Weber-reguson?
    access to maxilla, via insicion around nose up to orbit
  17. What type of surgery is done if node metastasis?
    composite resection, radical neck dissection (including CN XI), modified (excludes CN XI), selective
  18. What is the process of grafting?
    prepare recipient site, immobilize, prevent infection
  19. What are the phases of osteogenesis?
    • I: remaining living graft cells
    • II: BMP mobilized pluripotent cells to use graft as framework
  20. What are the phases of skin graftin?
    • adhesion: fibrin
    • nutritions: diffusion
    • circuation:
    • attachment: fibroblast
  21. Types of flaps?
    • flap, composite of skin never separated from vascular supply
    • random pattern: 2-3:1 length to base
    • axial: known vascular axis 4-5:1
    • Musculocutaneous: dominant blood supply for entire muscle
    • composite free flap
  22. What is the biggest advance in H & N reconstruction?
    • composite free flap: skin, fascia, muscle & bone supplied by vessels large enough for microvascular anastamosis
    • Heals like fracture, not graft
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2013-02-15 06:41:25
schwartz OSD5

schwartz OSD5
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