Surgical oncology of the oral and maxillofacial region

Any suspicious lesion or mass in the region of the face and neck, or inside or around the mouth, should be examined immediately and with no delay by an oral and maxillofacial surgeon, after of course an initial evaluation made by the dentist or the otorhinolaryngologist, which usually are the first doctors to see those patients. Nodules and ulcers or red or white plaques (erythroplakia/leucoplakia) can be signs of oral cancer. During initial examination the oral and maxillofacial surgeon can diagnose potential precancerous conditions or even manifestations of oral cancer, using the taking of biopsy (i.e. the surgical removal of a part of suspicious tissue), and the following histopathological examination, which gives with accuracy the diagnosis of the problem, as well as particular paraclinical examinations to confirm the existence of malignancy. It should be well understood by everyone, that primary diagnosis and treatment of oral cancer contribute greatly to increase the possibility for complete cure and rehabilitation.

Scientific research has shown that a number of predisposing factors can contribute to the appearance of oral cancer. The most usual are the use (or rather the abuse) of tobacco and alcohol. Other predisposing factors include poor oral hygiene, irritations and injuries caused by misapplication of dentures and by the existence of irregular surfaces on the existing teeth (e.g. botched fillings etc.), bad nutrition, as well as combinations of these factors. Various multicentric studies have shown that oral cancer’s mortality is almost four times higher for smokers than for non-smokers. It is also widely accepted in the medical community that heating produced by pipes and cigars, irritates the oral mucosa (the inner soft lining of mouth), and can lead to the development of oral and lip cancer.

The oral and maxillofacial surgeon is the head and neck surgeon par excellence who not only contributes to the diagnosis, but proceeds to the surgical management of oral cancer consisting of the surgical excision and the following reconstruction of the resulting deficits. In some complex cases, the collaboration of oral and maxillofacial surgeons with plastic and reconstructive surgeons, guarantees for the perfect functional and esthetic result for oncologic patients, whereas radiotherapy and chemotherapy or/and their combination which usually follow, ensure the surgical result contributing to the increase of life expectancy of these patients.