bubble_chart Overview

Malignant tumors in the oral and maxillofacial region are most commonly carcinomas, with squamous cell carcinoma being the most prevalent among them. In China, oral and maxillofacial squamous cell carcinoma predominantly occurs between the ages of 40-60, with a higher incidence in males than females. The most common types include gingival carcinoma, carcinoma of tongue, buccal carcinoma, palatal carcinoma, and maxillary sinus carcinoma. In regions north of the Yangtze River, oral carcinomas account for

1. 45-
2. 6% of all malignant tumors in the body, while in regions south of the Yangtze, the proportion is 1

．75-5.18%. In India, this figure can be as high as over 40% of all malignant tumors. Carcinoma of tongue is a common malignant tumor in the oral and maxillofacial region, occurring more frequently in males than females. Most cases are squamous cell carcinomas, particularly in the anterior two-thirds of the tongue, while adenocarcinomas are relatively rare and mostly located at the base of the tongue. Lymphoepithelial carcinoma and undifferentiated carcinoma may also occasionally occur at the base of the tongue.

bubble_chart Epidemiology

﹝Complications﹞

﹝Efficacy Evaluation﹞

bubble_chart Etiology

The exact cause of oral cancer is not yet fully understood, but the current consensus is that most cases are related to environmental factors. External factors such as heat, chronic injury, ultraviolet rays, X-rays, and other radioactive substances can act as carcinogens. For example, cancers of the tongue and buccal mucosa often occur in areas subjected to long-term, frequent irritation from residual roots, sharp tooth edges, or poorly fitted dental prostheses. Additionally, internal factors such as neuropsychiatric influences, endocrine factors, the body's immune status, and genetic predisposition have also been linked to the development of oral cancer. Typically, oral cancer is preceded by a precancerous stage, such as oral leukoplakia, traumatic ulcers, or papillomas.

bubble_chart Diagnosis

1. It is commonly seen at the margins of the tongue, followed by the tip, dorsum, and ventral surface of the tongue, and may have a history of local leukoplakia or chronic irritative factors.

2. It often presents as an ulcerative or infiltrative type, grows rapidly, causes significant pain, and has strong invasiveness.

3. There may be restricted tongue movement, difficulty in eating and swallowing.

4. Cervical lymph node metastasis often occurs early.

[Ancillary Examinations]

1. For cases with typical clinical manifestations and localized tumors, the examination items are mainly within the scope of "A."

2. For cases with atypical clinical manifestations, difficult differential diagnosis, large tumors closely related to surrounding critical structures, or suspected metastasis, the examination items may include the scope of "B" and "C." {|106|}

bubble_chart Treatment Measures

Comprehensive treatment primarily based on surgery generally involves the resection of the primary lesion and neck lymph node dissection, combined with radiotherapy or chemotherapy before or after surgery.

For prophylactic anti-infection in general surgery, sulfonamides (such as compound formula co-trimoxazole) or drugs primarily effective against Gram-positive bacteria (such as erythromycin, penicillin, etc.) are usually selected. For more extensive surgeries, such as those involving bone grafting or complex reconstructions, combination therapy is typically employed, commonly including: drugs effective against Gram-positive bacteria (e.g., penicillin) + drugs effective against Gram-negative bacteria (e.g., gentamicin) + drugs effective against anaerobic bacteria (e.g., metronidazole). In cases of severe pre- or postoperative infection or large and complex surgical wounds, effective antibiotics can be selected based on clinical evaluation and drug sensitivity testing. Chemotherapy can be used in conjunction with surgery before or after the procedure. Due to its severe side effects, it should be administered under close medical supervision, with careful monitoring of blood counts and other parameters.

bubble_chart Prognosis

The prevention of oral cancer lies in reducing external irritants, actively treating precancerous lesions, and enhancing the body's disease resistance. With the advancement of modern treatment techniques, the treatment of oral cancer has achieved better outcomes. Many patients, upon learning they have oral cancer, often consider it incurable and fail to seek active treatment, or they harbor侥幸心理, relying on folk remedies, which delays the condition and misses treatment opportunities. Early detection and early treatment should be emphasized, with comprehensive treatment as the main approach. Combining other treatment methods with surgical intervention for a systematic and thorough treatment can yield favorable results. Additionally, carcinoma of the tongue is the most prone to metastasis among oral cancers. It is generally recommended to perform selective (prophylactic) neck lymph node dissection (i.e., dissecting the affected lymph nodes even when no clinical signs of metastasis are present) concurrently with surgery. Clinical observations show that patients who undergo selective neck dissection simultaneously have higher cure rates compared to those who receive therapeutic neck dissection after lymph node metastasis is detected.

Cure Criteria

1. Cured: After treatment, the original follicular tumor and metastatic sources have been completely removed or disappeared, and the wound has largely healed.

2. Improved: After treatment, the tumor has shrunk, and symptoms have alleviated.

3. Not Cured: After treatment, the tumor shows no reduction, and symptoms remain unchanged.

bubble_chart Differentiation

1. Persistent ulcers on the lingual margin, tip, dorsum, or ventral surface of the tongue.

2. Rapid growth, pain, firm texture, indistinct borders, and tenderness.

3. Restricted tongue movement, difficulty in eating and swallowing.

4. Confirmed by histopathological examination.