Treatment of tumors of the oropharynx

In the treatment of tumors of the oropharynx, surgery, radiotherapy and their combination are mainly used.

Oral approach

 * It is used for small, superficial, exophytically growing tumors, such as the tongue , floor of the mouth , palate, uvula or tonsils.
 * The tumor must be reachable from the mouth, it must not spread to the bottom.
 * A CO 2 laser is often used.

External access

 * As a rule, it follows a block dissection of the neck nodes.
 * We have two types:


 * 1) Procedures not cutting the mandible
 * 2) * Pull through :
 * 3) ** it is a combined resection from the neck and oral approach.
 * 4) * Procedures without resection of the mandible are performed for tumors of the floor of the mouth and root of the tongue.
 * 5) * If the alveolar process is affected - a partial mandibulectomy is also performed;
 * 6) ** is to extract a segment of the process without violating the mandibular shoulder.
 * 7) * The resection is extended into the neck surgical wound and removed.
 * 8) * Lateral pharyngotomy :
 * 9) ** is used for the treatment of tumors of the root of the tongue and tonsillar fossa;
 * 10) ** we penetrate the pharynx behind the big corner of the tongue.
 * 11) * Medial pharyngotomy (suprahyoid) :
 * 12) ** the second traditional procedure;
 * 13) ** we penetrate just above the tongue in the area of ​​the glossoepiglottic valleculae;
 * 14) ** most often for small medially located tumors of the root of the tongue.
 * 15) Procedures violating the continuity of the mandible
 * 16) * All larger operations.
 * 17) * Either it is a temporary resection with subsequent osteosynthesis or it is segmentally resected.
 * 18) * Temporary mandibulotomy (mandibular split):
 * 19) ** the biggest advantage is the clarity of the operating field;
 * 20) ** may be medial or paramedian (through the foramen mentale) or lateral;
 * 21) ** good aesthetic result, but the mandible heals poorly with simultaneous radiotherapy.
 * 22) * The most radical approach :
 * 23) ** resection of the lateral segment of the mandible that is in contact with the tumor;
 * 24) ** in one block together with soft tissues are removed;
 * 25) ** the jaw moves to the operated side – the occlusion is imperfect, bad chewing;
 * 26) ** bone reconstruction of the mandible is usually not performed, it will not help functionally.
 * 27) * Resection of the medial segment :
 * 28) ** in extensive base tumors;
 * 29) ** disastrous aesthetic and functional results → bone reconstruction is done, usually from the fibula.

Therapy of nodal metastases

 * Part of the treatment of every tumor of the oropharynx.
 * Surgically, it is always a block dissection.
 * In N0 usually supraomohyoid (area I to III);
 * we will remove it and, in case of a positive finding, complete a complete block dissection.

related articles

 * Tumors of the oropharynx
 * Tumors of the epipharynx

Source

 * BENEŠ, Jiří. Study materials  [online]. ©2007. [feeling. 14/12/2011]. < http://jirben2.chytrak.cz/materialy/orl_jb.doc&#x20;&#x3E;.